Provider Demographics
NPI:1053902213
Name:TEXAS SUPERIOR CARE RX, LLC
Entity type:Organization
Organization Name:TEXAS SUPERIOR CARE RX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:OLANREWAJU
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:AYILEKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-652-4220
Mailing Address - Street 1:111 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MCCAMEY
Mailing Address - State:TX
Mailing Address - Zip Code:79752
Mailing Address - Country:US
Mailing Address - Phone:432-652-4220
Mailing Address - Fax:432-652-4224
Practice Address - Street 1:111 E 5TH ST
Practice Address - Street 2:
Practice Address - City:MCCAMEY
Practice Address - State:TX
Practice Address - Zip Code:79752
Practice Address - Country:US
Practice Address - Phone:432-652-4220
Practice Address - Fax:432-652-4224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-31
Last Update Date:2021-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy