Provider Demographics
NPI:1700245503
Name:IDEAL PHARMACY
Entity Type:Organization
Organization Name:IDEAL PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:DEAL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:281-728-9761
Mailing Address - Street 1:24601 HOSFORD MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-3083
Mailing Address - Country:US
Mailing Address - Phone:832-834-7463
Mailing Address - Fax:832-834-7457
Practice Address - Street 1:2904 FULTON ST STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-5792
Practice Address - Country:US
Practice Address - Phone:832-834-7463
Practice Address - Fax:832-834-7457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX306353336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy