Provider Demographics
NPI:1053750901
Name:BIRDSONGS ENTERPRISES INC
Entity type:Organization
Organization Name:BIRDSONGS ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:PARTHIV
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGHWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-628-7186
Mailing Address - Street 1:4002 GARTH ROAD #140A
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521
Mailing Address - Country:US
Mailing Address - Phone:281-628-7186
Mailing Address - Fax:281-628-7188
Practice Address - Street 1:4002 GARTH RD STE 140A
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3179
Practice Address - Country:US
Practice Address - Phone:281-628-7186
Practice Address - Fax:281-628-7188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-24
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
TX286013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146795Medicaid
2140866OtherPK