Healthcare Provider Details

I. General information

NPI: 1053273656
Provider Name (Legal Business Name): HOUSTON RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 N HOUSTON RD
WARNER ROBINS GA
31093-3040
US

IV. Provider business mailing address

608 S HOUSTON LAKE RD
WARNER ROBINS GA
31088-6310
US

V. Phone/Fax

Practice location:
  • Phone: 404-855-9475
  • Fax:
Mailing address:
  • Phone: 478-333-6767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ATIT PATEL
Title or Position: PHARMACIST IN CHARGE
Credential: PHARMD
Phone: 404-855-9475