Provider Demographics
NPI:1508356908
Name:HEALTHY LIFE PROFESSIONAL PHARMACY
Entity Type:Organization
Organization Name:HEALTHY LIFE PROFESSIONAL PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:RYANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-495-1980
Mailing Address - Street 1:11226 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-3604
Mailing Address - Country:US
Mailing Address - Phone:281-495-1980
Mailing Address - Fax:281-495-1987
Practice Address - Street 1:11226 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031
Practice Address - Country:US
Practice Address - Phone:281-495-1980
Practice Address - Fax:281-495-1987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX319653336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy