Provider Demographics
NPI:1962652396
Name:FILLASCRIPT INC
Entity Type:Organization
Organization Name:FILLASCRIPT INC
Other - Org Name:MEDITEX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-875-5735
Mailing Address - Street 1:3010 S RICHEY ST
Mailing Address - Street 2:STE C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77017-7220
Mailing Address - Country:US
Mailing Address - Phone:713-401-3536
Mailing Address - Fax:713-943-9696
Practice Address - Street 1:3010 S RICHEY ST
Practice Address - Street 2:STE C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-7220
Practice Address - Country:US
Practice Address - Phone:713-401-3536
Practice Address - Fax:713-943-9696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4549715OtherNCPDP PROVIDER IDENTIFICATION NUMBER