Healthcare Provider Details

I. General information

NPI: 1053736041
Provider Name (Legal Business Name): CUSTOM MEDS PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2014
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23406 KINGSLAND BLVD STE 100
KATY TX
77494-8469
US

IV. Provider business mailing address

23406 KINGSLAND BLVD STE 100
KATY TX
77494-8469
US

V. Phone/Fax

Practice location:
  • Phone: 832-431-5449
  • Fax: 832-431-5439
Mailing address:
  • Phone: 832-431-5449
  • Fax: 832-431-5439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number29041
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. VICTORIA ANAGHARA
Title or Position: PRESIDENT
Credential: PHARM D
Phone: 832-431-5449