Provider Demographics
NPI:1861785370
Name:PLAZA APOTHECARY PLLC
Entity type:Organization
Organization Name:PLAZA APOTHECARY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING PARTNER
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:P.O. 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:214-855-0606
Mailing Address - Fax:214-855-0609
Practice Address - Street 1:600 N PEARL STREET, STE H201
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-7430
Practice Address - Country:US
Practice Address - Phone:214-855-0606
Practice Address - Fax:214-855-0609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X, 3336C0003X
TX27490333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX27490OtherTEXAS STATE BOARD OF PHARMACY