Provider Demographics
NPI:1104185982
Name:MEDSHOPPE RX PHARMACY
Entity Type:Organization
Organization Name:MEDSHOPPE RX PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FELISITA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-492-0899
Mailing Address - Street 1:14522 S POST OAK RD
Mailing Address - Street 2:#108-A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045-6037
Mailing Address - Country:US
Mailing Address - Phone:713-492-0899
Mailing Address - Fax:
Practice Address - Street 1:14522 S POST OAK RD
Practice Address - Street 2:#108-A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77045-6037
Practice Address - Country:US
Practice Address - Phone:713-492-0899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27385333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy