Provider Demographics
NPI:1194576363
Name:PMPTX LLC
Entity type:Organization
Organization Name:PMPTX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KUMARI UNNATI
Authorized Official - Middle Name:
Authorized Official - Last Name:YADAV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-374-2303
Mailing Address - Street 1:1004 BROADWAY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:GLADEWATER
Mailing Address - State:TX
Mailing Address - Zip Code:75647-2534
Mailing Address - Country:US
Mailing Address - Phone:903-374-2303
Mailing Address - Fax:903-309-1031
Practice Address - Street 1:1004 BROADWAY AVE STE A
Practice Address - Street 2:
Practice Address - City:GLADEWATER
Practice Address - State:TX
Practice Address - Zip Code:75647-2534
Practice Address - Country:US
Practice Address - Phone:903-374-2303
Practice Address - Fax:903-309-1031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy