Provider Demographics
NPI:1710337316
Name:KATY PHARMACY & DRUG STORE
Entity Type:Organization
Organization Name:KATY PHARMACY & DRUG STORE
Other - Org Name:KATY PHARMACY 3
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MILAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTALLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-804-9897
Mailing Address - Street 1:25115 GOSLING RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389
Mailing Address - Country:US
Mailing Address - Phone:832-953-2611
Mailing Address - Fax:832-953-2613
Practice Address - Street 1:20005 KATY FWY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2238
Practice Address - Country:US
Practice Address - Phone:832-953-2611
Practice Address - Fax:832-953-2613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy