Provider Demographics
NPI:1962757898
Name:LMR WEBSTER STREET PHARMACY INCORPORATED
Entity type:Organization
Organization Name:LMR WEBSTER STREET PHARMACY INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASIM
Authorized Official - Middle Name:
Authorized Official - Last Name:JILANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-288-4466
Mailing Address - Street 1:11519 WALLISVILLE RD STE 500
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77049
Mailing Address - Country:US
Mailing Address - Phone:281-288-4466
Mailing Address - Fax:281-288-4477
Practice Address - Street 1:11519 WALLISVILLE RD STE 500
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049
Practice Address - Country:US
Practice Address - Phone:281-288-4466
Practice Address - Fax:281-288-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX271483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2141217OtherPK