Provider Demographics
NPI:1639590516
Name:TEXAS HEALTH RX, LLC
Entity type:Organization
Organization Name:TEXAS HEALTH RX, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TUAN
Authorized Official - Middle Name:NGOC
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-458-0270
Mailing Address - Street 1:616 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-3325
Mailing Address - Country:US
Mailing Address - Phone:817-458-0270
Mailing Address - Fax:877-919-9331
Practice Address - Street 1:616 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065
Practice Address - Country:US
Practice Address - Phone:817-458-0270
Practice Address - Fax:877-919-9331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX288613336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB0202678OtherDEPARTMENT OF PUBLIC SAFETY
TX28861OtherTEXAS STATE BOARD OF PHARMACY LICENSE
TX28861OtherTEXAS STATE BOARD OF PHARMACY LICENSE