MEDICARE: SPECIALIZED RX, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	25309	TX
2	3336L0003X	Long Term Care Pharmacy	25309	TX
3	3336S0011X	Specialty Pharmacy	25309	TX
4	3336C0004X	Compounding Pharmacy	25309	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	25309	OTHER	TX	TX STATE BOARD PHARMACY

General Provider Information

NPI Number	:	1275675167
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIALIZED RX, INC

Provider Business Mailing Address
First Line	:	1416 N SAM HOUSTON PKWY E
Second Line	:	STE 160
City	:	HOUSTON
State	:	TX
Zip	:	77032-2960
Country	:	US
Telephone Number	:	281-987-8500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1416 N SAM HOUSTON PKWY E
Second Line	:	STE 160
City	:	HOUSTON
State	:	TX
Zip	:	77032-2960
Country	:	US
Telephone Number	:	281-987-8500
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. SEAN FANNING
Credential	:
Telephone Number	:	281-987-8500

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	09/11/2025

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Directions to “SPECIALIZED RX, INC ” Practice Location

Language	Start Address	Practice Location

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