Healthcare Provider Details

I. General information

NPI: 1407935679
Provider Name (Legal Business Name): MAXMED CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 NORMANDY ST SUITE 200
HOUSTON TX
77015-4920
US

IV. Provider business mailing address

902 NORMANDY ST SUITE 200
HOUSTON TX
77015-4920
US

V. Phone/Fax

Practice location:
  • Phone: 713-451-0200
  • Fax:
Mailing address:
  • Phone: 713-451-0200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number118718
License Number StateTX

VIII. Authorized Official

Name: KAWN H LEE
Title or Position: PRESIDENT
Credential:
Phone: 713-451-0200