Provider Demographics
NPI:1053126672
Name:GLEAUX RX IV DRIP BAR AND MED SPA
Entity type:Organization
Organization Name:GLEAUX RX IV DRIP BAR AND MED SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:337-912-4030
Mailing Address - Street 1:725 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:NEW ROADS
Mailing Address - State:LA
Mailing Address - Zip Code:70760-2630
Mailing Address - Country:US
Mailing Address - Phone:225-713-3662
Mailing Address - Fax:
Practice Address - Street 1:725 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:NEW ROADS
Practice Address - State:LA
Practice Address - Zip Code:70760-2630
Practice Address - Country:US
Practice Address - Phone:225-713-3662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GLEAUX RX IV DRIP BAR AND MED SPA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty