Healthcare Provider Details

I. General information

NPI: 1124321781
Provider Name (Legal Business Name): MEDEX HEALTH CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2010
Last Update Date: 01/07/2022
Certification Date: 01/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 FONDREN RD STE B3
HOUSTON TX
77096-3682
US

IV. Provider business mailing address

7007 BALLINGER RIDGE LN
RICHMOND TX
77407-4058
US

V. Phone/Fax

Practice location:
  • Phone: 713-771-3800
  • Fax: 713-771-3801
Mailing address:
  • Phone: 832-275-2814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number27255
License Number StateTX

VIII. Authorized Official

Name: JOSEPH UKONU
Title or Position: CEO
Credential:
Phone: 832-275-2814