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General NPI Number Information
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NPI Number | 1174003552
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Entity Type | Organization
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Legal Business Name | LIVE OAK PHARMACY,LLC
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Dates
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Enumeration Date | 08/15/2018
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 2011 W SPRING CREEK PKWY STE 1500
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City | PLANO
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State | TX
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Zip | 75023-4260
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Country | US
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Telephone | 972-532-1008
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Fax |
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Provider Business Mailing Address
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Address Line | 2011 W SPRING CREEK PKWY STE 1500
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City | PLANO
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State | TX
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Zip | 75023-4260
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | BILAL ABU ATIEH
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Credential |
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Telephone | 972-532-1008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 32209
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License Number State | TX
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