Healthcare Provider Details

I. General information

NPI: 1952017287
Provider Name (Legal Business Name): PROSXYSRX-LA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8120 MAIN ST STE 100
HOUMA LA
70360-3403
US

IV. Provider business mailing address

320 S POLK ST STE 200
AMARILLO TX
79101-1436
US

V. Phone/Fax

Practice location:
  • Phone: 985-333-2433
  • Fax: 985-333-2434
Mailing address:
  • Phone: 806-242-7782
  • Fax: 469-617-2052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. JOEL WRIGHT
Title or Position: PRESIDENT PHARMACY SERVICES
Credential:
Phone: 806-242-7782