Provider Demographics
NPI:1154616605
Name:STEEPLECHASE PLAZA PHARMACY
Entity type:Organization
Organization Name:STEEPLECHASE PLAZA PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:
Authorized Official - First Name:REZIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SAQER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-237-9400
Mailing Address - Street 1:11037 FM 1960 RD WEST
Mailing Address - Street 2:SUITE B5
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065
Mailing Address - Country:US
Mailing Address - Phone:832-237-9400
Mailing Address - Fax:832-688-8196
Practice Address - Street 1:11037 FM 1960 RD W
Practice Address - Street 2:SUITE B5
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3600
Practice Address - Country:US
Practice Address - Phone:281-894-6167
Practice Address - Fax:281-894-6195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-13
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX274823336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX27482OtherSTATE PHARMACY LICENSE