Organization Active NPI

Miracle Pharmacy Inc.

  • Community/Retail Pharmacy
  • Houston, TX
National Provider Identifier
1134627938
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MIRACLE PHARMACY INC.
Practice address
15825 Bellaire Blvd Ste E
Houston, TX 77083-2353
Phone
(281) 809-5707
Fax
(281) 809-5703
NPI assigned
Jan 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anthony Igbokwe
Title
Officer
Phone
(713) 614-7397

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

15825 Bellaire Blvd Ste E
Houston, TX 77083-2353

Mailing address

19819 Redwood Tree St
Richmond, TX 77407-7113
Phone (713) 614-7397

Other identifiers 1

IdentifierTypeStateIssuer
149940MedicaidTX

National Provider Directory

National Provider Directory

Locations

8449 W Bellfort Ave
Ste 130
Houston, TX 77071
Phone (713) 485-6461

15825 Bellaire Blvd
Ste E
Houston, TX 77083
Phone (281) 809-5707

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1134627938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19819 REDWOOD TREE ST",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774077113",
            "telephone_number": "713-614-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15825 BELLAIRE BLVD STE E",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770832353",
            "telephone_number": "281-809-5707",
            "fax_number": "281-809-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "IGBOKWE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "713-614-7397"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149940",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.