MEDICARE: PUBLIC EXPRESS 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0004X	Compounding Pharmacy
3	333600000X	Pharmacy
4	3336C0003X	Community/Retail Pharmacy	16353	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2103916	OTHER	PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518942259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUBLIC EXPRESS INC

Provider Business Mailing Address
First Line	:	2532 FONDREN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-2308
Country	:	US
Telephone Number	:	713-782-6212
Fax Number	:	713-782-2001

Provider Business Practice Location Address
First Line	:	2532 FONDREN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-2308
Country	:	US
Telephone Number	:	713-782-6212
Fax Number	:	713-782-2001

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MARENE TOMPKINS
Credential	:
Telephone Number	:	713-461-5151

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	04/05/2016

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Directions to “PUBLIC EXPRESS INC ” Practice Location

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