Provider Demographics
NPI:1588799795
Name:SAENZ MEDICAL PHARMACY LONE STAR, INC.
Entity Type:Organization
Organization Name:SAENZ MEDICAL PHARMACY LONE STAR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:SAENZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:956-687-2500
Mailing Address - Street 1:2121 E GRIFFIN PKWY
Mailing Address - Street 2:SUITE 18
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3241
Mailing Address - Country:US
Mailing Address - Phone:956-519-6500
Mailing Address - Fax:956-519-6524
Practice Address - Street 1:2121 E GRIFFIN PKWY
Practice Address - Street 2:SUITE 18
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3241
Practice Address - Country:US
Practice Address - Phone:956-519-6500
Practice Address - Fax:956-519-6524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TX231183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145376Medicaid
TX167743701Medicaid
TX163444601Medicaid
TX167743702Medicaid