Provider Demographics
NPI:1669962569
Name:ST. LUKE PHARMACY INC.
Entity type:Organization
Organization Name:ST. LUKE PHARMACY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAHBAZ
Authorized Official - Middle Name:JAVAID
Authorized Official - Last Name:CHAUDHARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-935-9092
Mailing Address - Street 1:2920 OAK LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-4214
Mailing Address - Country:US
Mailing Address - Phone:214-935-9092
Mailing Address - Fax:469-372-6847
Practice Address - Street 1:2920 OAK LAWN AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4214
Practice Address - Country:US
Practice Address - Phone:214-935-9092
Practice Address - Fax:469-372-6847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58083183500000X
332B00000X, 3336C0004X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy