Provider Demographics
NPI:1659647444
Name:TECHNODREAN INC
Entity Type:Organization
Organization Name:TECHNODREAN INC
Other - Org Name:SUGAR LAND COMPOUNDING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHID
Authorized Official - Middle Name:JAKI
Authorized Official - Last Name:UDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:972-768-9352
Mailing Address - Street 1:14891 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5016
Mailing Address - Country:US
Mailing Address - Phone:281-302-6080
Mailing Address - Fax:
Practice Address - Street 1:14891 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5016
Practice Address - Country:US
Practice Address - Phone:281-302-6080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TECHNODREAN INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX333600000X333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy