MEDICARE: ADRX 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	25475	TX

General Provider Information

NPI Number	:	1619199908
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADRX INC

Provider Business Mailing Address
First Line	:	2025 MANGUM RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-8529
Country	:	US
Telephone Number	:	713-812-8400
Fax Number	:	713-812-8401

Provider Business Practice Location Address
First Line	:	2025 MANGUM RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77092-8529
Country	:	US
Telephone Number	:	713-812-8400
Fax Number	:	713-812-8401

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. LORI MARISA LEAL
Credential	:	PHARM D
Telephone Number	:	713-208-7252

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	08/22/2020

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Directions to “ADRX INC ” Practice Location

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