Spence Medical Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

19462 Issued in TX

Legal business name

SPENCE MEDICAL PHARMACY LLC

Doing business as

Spence Medical Center Pharmacy

Practice address

2301 E Mulberry St
Angleton, TX 77515-3804

Phone

(979) 849-9391

Fax

(979) 848-0900

NPI assigned

Aug 10, 2006

Last updated

Jun 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jose A Vela, R.PH.

Title

President/Owner

Phone

(956) 583-2700

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Spence Medical Center Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

Spence Medical Center Pharmacy2 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.

• Spence Medical Pharmacy, LLC

  dba Spences Medical Center Pharmacy

  • Long Term Care Pharmacy
  • Angleton, TX
  • NPI 1518762475
  NPD tax ID

Locations

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1811908304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 PAMELA, STE B",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "78572",
            "telephone_number": "956-583-2700",
            "fax_number": "956-583-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E MULBERRY ST",
            "city": "ANGLETON",
            "state": "TX",
            "postal_code": "775153804",
            "telephone_number": "979-849-9391",
            "fax_number": "979-848-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPENCE MEDICAL PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2024-06-07",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "VELA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "956-583-2700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "19462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148745",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4579910",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spence Medical Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dayna Snyder, OT
• Holly Nicole Soderman, EISP
• Soleana Stables
• Laura Soria, RN
• Ruth Elizabeth Soulsby-Monroy, CNM
• Spence Medical Pharmacy, LLC (Spences Medical Center Pharmacy)
• Tina Marie Spencer, WHCNP
• Janice Spittler-Baldwin, SLP CCC
• Stephen F Austin Community Health Center, Inc (Angleton Internal Medicine and Primary Care)
• Stephen F Austin Community Health Center, Inc (Mychn Technology Drive)

• Community/Retail Pharmacy in Angleton, TX
• Providers in Angleton, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.