Provider Demographics
NPI:1285958389
Name:CHLOLINDAK CORPORATION
Entity type:Organization
Organization Name:CHLOLINDAK CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTEAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-987-3300
Mailing Address - Street 1:11524 SPACE CENTER BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77059-3603
Mailing Address - Country:US
Mailing Address - Phone:281-487-9090
Mailing Address - Fax:281-487-9098
Practice Address - Street 1:11524 SPACE CENTER BLVD STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77059-3603
Practice Address - Country:US
Practice Address - Phone:281-487-9090
Practice Address - Fax:281-487-9098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX271513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146249Medicaid
2126734OtherPK