Healthcare Provider Details

I. General information

NPI: 1871438457
Provider Name (Legal Business Name): ONE TRUSTED ENSURED SOURCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5720 BELLAIRE BLVD STE B
HOUSTON TX
77081-5513
US

IV. Provider business mailing address

5720 BELLAIRE BLVD STE B
HOUSTON TX
77081-5513
US

V. Phone/Fax

Practice location:
  • Phone: 346-571-6373
  • Fax:
Mailing address:
  • Phone: 346-571-6373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PATSY CARAWAY
Title or Position: OWNER
Credential:
Phone: 346-571-6373