Healthcare Provider Details

I. General information

NPI: 1134038185
Provider Name (Legal Business Name): EMBARK RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26077 NELSON WAY STE 1401
KATY TX
77494-6699
US

IV. Provider business mailing address

26077 NELSON WAY STE 1401
KATY TX
77494-6699
US

V. Phone/Fax

Practice location:
  • Phone: 888-662-9079
  • Fax:
Mailing address:
  • Phone: 888-662-9079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0207X
TaxonomyCompounded Sterile Preparations Pharmacist
License Number
License Number State

VIII. Authorized Official

Name: JEREMY BOURGEOIS
Title or Position: PARTNER
Credential:
Phone: 512-925-9755