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Lakeside Pharmacy LLC

Lakeside Pharmacy LLC is a healthcare organization registered as Long Term Care Pharmacy in Montgomery, TX, holding Type 2 (organization) NPI 1780468884 since 2023. The authorized official on file is Kim Prezioso, Owner/Pic.

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NPI 1780468884
Entity type Organization (Type 2)
Legal business name Lakeside Pharmacy LLC
Practice address 16955 WALDEN RD STE 100, Montgomery, TX, 77356
Phone 9364486337
Fax 9364486338
Enumeration date 2023-08-21
Last updated in NPPES 2023-08-21

Authorized official

Name Kim Prezioso
Title Owner/Pic
Phone 9364486337

Taxonomy & classification

Taxonomy code Specialty Primary License State
3336L0003X Long Term Care Pharmacy Primary
Copy-ready billing details
Provider: Lakeside Pharmacy LLC
NPI: 1780468884
Taxonomy: 3336L0003X (Long Term Care Pharmacy)
Address: 16955 WALDEN RD STE 100, Montgomery, TX, 77356

Providers at this address

NPI Name Type Specialty Location
1013239417 Lakeside Pharmacy LLC Organization Community/Retail Pharmacy Montgomery, TX

Verify this record

Cross-check NPI 1780468884 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

Where is Lakeside Pharmacy LLC located?
The practice location on file with NPPES is in Montgomery, TX.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2023-08-21. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-08-21.