Lakeside Pharmacy LLC
Lakeside Pharmacy LLC is a healthcare organization registered as Community/Retail Pharmacy in Montgomery, TX, holding Type 2 (organization) NPI 1013239417 since 2010. The authorized official on file is Kim Prezioso, President/Pharm-in-Charge.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1013239417 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Lakeside Pharmacy LLC |
| Other name | <Unavail> |
| Practice address | 16955 WALDEN RD STE 100, Montgomery, TX, 77356 |
| Phone | 9364486337 |
| Fax | 9364486338 |
| Enumeration date | 2010-02-26 |
| Last updated in NPPES | 2010-04-07 |
Authorized official
| Name | Kim Prezioso |
|---|---|
| Title | President/Pharm-in-Charge |
| Phone | 9368273766 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 3336C0004X | Compounding Pharmacy | Secondary | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 333600000X | Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 26843 | TX |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4555186 | Other | — | NCPDP PROVIDER IDENTIFICATION NUMBER |
Copy-ready billing details
Provider: Lakeside Pharmacy LLC NPI: 1013239417 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 16955 WALDEN RD STE 100, Montgomery, TX, 77356
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1780468884 | Lakeside Pharmacy LLC | Organization | Long Term Care Pharmacy | Montgomery, TX |
Verify this record
Cross-check NPI 1013239417 against the authoritative CMS record: view Lakeside Pharmacy LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Lakeside Pharmacy LLC?
What is the NPI number for Lakeside Pharmacy LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2010-04-07.