Provider Demographics
NPI:1912194739
Name:LATIN AMERICAN DRUGS INC
Entity Type:Organization
Organization Name:LATIN AMERICAN DRUGS INC
Other - Org Name:PHARMACIA LATINA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OSAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAAD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:713-683-6004
Mailing Address - Street 1:1836 WIRT RD STE B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-2469
Mailing Address - Country:US
Mailing Address - Phone:713-683-6004
Mailing Address - Fax:713-683-8618
Practice Address - Street 1:1836 WIRT RD STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-2469
Practice Address - Country:US
Practice Address - Phone:713-683-6004
Practice Address - Fax:713-683-8618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX257053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2100396OtherPK
TX148665Medicaid