Provider Demographics
NPI:1487175311
Name:FRISCO APOTHECARY, LP
Entity type:Organization
Organization Name:FRISCO APOTHECARY, LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJ
Authorized Official - Middle Name:MILAN
Authorized Official - Last Name:CHHADUA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:214-422-2598
Mailing Address - Street 1:PO BOX 2735
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0051
Mailing Address - Country:US
Mailing Address - Phone:469-294-2001
Mailing Address - Fax:
Practice Address - Street 1:3010 LEGACY DR STE 110
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7629
Practice Address - Country:US
Practice Address - Phone:469-924-2001
Practice Address - Fax:469-888-8448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-30
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X, 3336C0003X, 3336C0004X
TX31461333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX31461OtherTEXAS STATE BOARD OF PHARMACY