Provider Demographics
NPI:1780231308
Name:RX HEALER INC
Entity Type:Organization
Organization Name:RX HEALER INC
Other - Org Name:SPENCER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DEIDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-693-6888
Mailing Address - Street 1:1611 F SPENCER HWY SOUTH
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77587
Mailing Address - Country:US
Mailing Address - Phone:713-534-1302
Mailing Address - Fax:713-534-1306
Practice Address - Street 1:1611 F SPENCER HWY SOUTH
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77587
Practice Address - Country:US
Practice Address - Phone:713-534-1302
Practice Address - Fax:713-534-1306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-19
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX691064Medicaid