Healthcare Provider Details

I. General information

NPI: 1669487286
Provider Name (Legal Business Name): MILITARY APOTHECARY LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 N LOOP 1604 W STE 104
SAN ANTONIO TX
78232-1456
US

IV. Provider business mailing address

PO BOX 2735
FRISCO TX
75034-0051
US

V. Phone/Fax

Practice location:
  • Phone: 210-802-0553
  • Fax:
Mailing address:
  • Phone: 469-294-2001
  • Fax: 469-888-8448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number24371
License Number StateTX

VIII. Authorized Official

Name: DR. RAJ MILAN CHHADUA
Title or Position: OWNER/MANAGING PARTNER
Credential: PHARMD
Phone: 214-422-2598