Provider Demographics
NPI:1871851733
Name:JANSPA MED SERVICES INC
Entity Type:Organization
Organization Name:JANSPA MED SERVICES INC
Other - Org Name:WEBSTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRES
Authorized Official - Prefix:
Authorized Official - First Name:DINESH
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAVSAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:832-551-7595
Mailing Address - Street 1:1302 SHADY GROVE CT
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:TX
Mailing Address - Zip Code:77586-4136
Mailing Address - Country:US
Mailing Address - Phone:832-551-7595
Mailing Address - Fax:
Practice Address - Street 1:13914 HIGHWAY 3 STE 700
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-1613
Practice Address - Country:US
Practice Address - Phone:281-886-7164
Practice Address - Fax:281-652-5345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX279833336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2134898OtherPK
TX148449Medicaid