Organization
MIRACLE PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY IGBOKWE (OFFICER)
(713) 614-7397
Entity
Organization
Contact information
Practice address
15825 BELLAIRE BLVD STE E, HOUSTON, TX 77083-2353
(281) 809-5707
(281) 809-5703
Mailing address
19819 REDWOOD TREE ST, RICHMOND, TX 77407-7113
(713) 614-7397
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149940
—
TX
Enumeration date
01/26/2018
Last updated
03/26/2021
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