Healthcare Provider Details

I. General information

NPI: 1144152430
Provider Name (Legal Business Name): COLLEGE PARK RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3115 COLLEGE PARK DR STE 103A
CONROE TX
77384-4173
US

IV. Provider business mailing address

3115 COLLEGE PARK DR STE 103A
CONROE TX
77384-4173
US

V. Phone/Fax

Practice location:
  • Phone: 936-321-4011
  • Fax:
Mailing address:
  • Phone: 936-321-4011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: HELI PATEL
Title or Position: OFFICER
Credential: PHARM D
Phone: 201-744-0107