Provider Demographics
NPI:1790266138
Name:SMARTHEAD INC
Entity Type:Organization
Organization Name:SMARTHEAD INC
Other - Org Name:TULIPANES PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OKWUDILI
Authorized Official - Middle Name:T
Authorized Official - Last Name:OKPARA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:281-762-2601
Mailing Address - Street 1:5182 AVENUE H
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2014
Mailing Address - Country:US
Mailing Address - Phone:281-762-2601
Mailing Address - Fax:281-763-2855
Practice Address - Street 1:5182 AVENUE H
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2014
Practice Address - Country:US
Practice Address - Phone:281-762-2601
Practice Address - Fax:281-763-2855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149941Medicaid