Provider Demographics
NPI:1568940492
Name:KATY DRUG PARTNERSHIP
Entity Type:Organization
Organization Name:KATY DRUG PARTNERSHIP
Other - Org Name:KATY MEDICAL PHARMACY, LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KORTHAUER
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CPHT
Authorized Official - Phone:979-251-0599
Mailing Address - Street 1:PO BOX 1197
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77834-1197
Mailing Address - Country:US
Mailing Address - Phone:281-829-6497
Mailing Address - Fax:281-829-5381
Practice Address - Street 1:21700 KINGSLAND BLVD STE 105
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2546
Practice Address - Country:US
Practice Address - Phone:281-829-6497
Practice Address - Fax:281-829-3581
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KATY DRUG PARTNERSHIP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-02
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX321733336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX24068OtherTEXAS STATE BOARD OF PHARMACY