| NPI | 1871775155 |
|---|---|
| Doing Business As | LAKESIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TOMAS CONTRERAS Owner 956-725-6337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 25807) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2015-12-31 |