Provider Demographics
NPI:1184510380
Name:ACTIVATE DRIP SPA LLC
Entity type:Organization
Organization Name:ACTIVATE DRIP SPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:346-809-3747
Mailing Address - Street 1:7925 KATY FWY STE I
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1957
Mailing Address - Country:US
Mailing Address - Phone:832-810-3747
Mailing Address - Fax:832-562-3747
Practice Address - Street 1:7925 KATY FWY STE I
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1957
Practice Address - Country:US
Practice Address - Phone:832-810-3747
Practice Address - Fax:832-562-3747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-16
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty