Provider Demographics
NPI:1386124659
Name:KATY PHARMACY INC
Entity type:Organization
Organization Name:KATY PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MARYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTALLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:281-578-1515
Mailing Address - Street 1:20005 KATY FWY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2238
Mailing Address - Country:US
Mailing Address - Phone:281-578-1515
Mailing Address - Fax:281-578-1511
Practice Address - Street 1:20005 KATY FWY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2238
Practice Address - Country:US
Practice Address - Phone:281-578-1515
Practice Address - Fax:281-578-1511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX275643336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy