Organization Active NPI

Pharma Source RX Inc

Community/Retail Pharmacy
Sugar Land, TX

National Provider Identifier

1700483112

Registry record updated Feb 2, 2022

On this page

Key facts
NPPES NPI Registry
National Provider Directory
NPI Registry JSON
Other providers in Sugar Land, TX
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name: PHARMA SOURCE RX INC
Practice address: 19855 Southwest Fwy.
Ste. 220
Sugar Land, TX 77479
Phone: (281) 762-2020
Fax: (832) 363-1014
NPI assigned: Oct 8, 2020
Last updated: Feb 2, 2022By the provider in NPPES
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Authorized official

Name: Ms. Laura Cantu
Title: Officer
Phone: (281) 762-2020

Specialties & licenses 2

Specialty (taxonomy)	Code	License	State	Primary
Community/Retail Pharmacy	3336C0003X		NU	Primary
Long Term Care Pharmacy	3336L0003X		NU

Addresses

Primary practice location

19855 Southwest Fwy.
Ste. 220
Sugar Land, TX 77479

Mailing address

19855 Southwest Fwy.
Ste. 220
Sugar Land, TX 77479
Phone (281) 762-2020

Other identifiers 2

Identifier	Type	State	Issuer
150346	Medicaid	TX
32071001211	Other	TX	TIN

Electronic endpoints 7

Type	Endpoint	Use
Other URL	Richmond	Direct
Other URL	Richmond	Health Information Exchange (HIE)
CONNECT URL	Rosenberg	Direct
Other URL	SugarLand	Direct
Other URL	SugarLand	Direct
Other URL	SugarLand	Health Information Exchange (HIE)
CONNECT URL	Richmond	Direct

National Provider Directory

Tax ID family: Pharma Source RX Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Pharma Source RX Inc
- Community/Retail Pharmacy
- Sugar Land, TX
- NPI 1811523905
NPD tax ID

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643760000000",
    "number": "1700483112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19855 SOUTHWEST FWY.",
            "address_2": "STE. 220",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "77479",
            "telephone_number": "281-762-2020",
            "fax_number": "832-363-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19855 SOUTHWEST FWY.",
            "address_2": "STE. 220",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "77479",
            "telephone_number": "281-762-2020",
            "fax_number": "832-363-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMA SOURCE RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A",
        "authorized_official_last_name": "CANTU",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "281-762-2020",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150346",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TIN",
            "identifier": "32071001211",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Richmond",
            "affiliation": "N",
            "endpointDescription": "Richmond",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Rosenberg",
            "address_1": "301 S 9th St Ste 109",
            "city": "Richmond",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774693448",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Richmond",
            "affiliation": "N",
            "endpointDescription": "Richmond",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Richmond",
            "address_1": "301 S 9th St Ste 109",
            "city": "Richmond",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774693448",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Rosenberg",
            "affiliation": "N",
            "endpointDescription": "Richmond",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "301 S 9th St Ste 109",
            "city": "Richmond",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774693448",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SugarLand",
            "affiliation": "N",
            "endpointDescription": "SugarLand",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "SugarLand",
            "address_1": "19855 Southwest Fwy Ste 220",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774796536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SugarLand",
            "affiliation": "N",
            "endpointDescription": "Richmond",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "19855 Southwest Fwy Ste 220",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774796536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SugarLand",
            "affiliation": "N",
            "endpointDescription": "Richmond",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "SugarLand",
            "address_1": "19855 Southwest Fwy Ste 220",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774796536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Richmond",
            "affiliation": "N",
            "endpointDescription": "Richmond",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "19855 Southwest Fwy Ste 220",
            "city": "Sugar Land",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774796536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; 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.