Provider Demographics
NPI:1861434649
Name:TXRX PHARMACY
Entity type:Organization
Organization Name:TXRX PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAAB
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:409-886-1412
Mailing Address - Street 1:2 PUTNAM AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-2328
Mailing Address - Country:US
Mailing Address - Phone:409-886-1412
Mailing Address - Fax:409-883-4913
Practice Address - Street 1:2 PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-2328
Practice Address - Country:US
Practice Address - Phone:409-886-1412
Practice Address - Fax:409-883-4913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX237543336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4540109OtherNCPDP PROVIDER IDENTIFICATION NUMBER