Provider Demographics
NPI:1649630906
Name:L.D. WALTER GROUP
Entity type:Organization
Organization Name:L.D. WALTER GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:LARONDA
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:713-330-8011
Mailing Address - Street 1:5415 KELLEY ST.
Mailing Address - Street 2:STE. D
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-0000
Mailing Address - Country:US
Mailing Address - Phone:713-330-8011
Mailing Address - Fax:713-330-3011
Practice Address - Street 1:5415 KELLEY ST.
Practice Address - Street 2:STE. D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-0000
Practice Address - Country:US
Practice Address - Phone:713-330-8011
Practice Address - Fax:713-330-3011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX297153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy