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General NPI Number Information
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NPI Number | 1023537743
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Entity Type | Organization
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Legal Business Name | PRO MED RX
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Dates
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Enumeration Date | 09/13/2017
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 5716 BELLAIRE BLDV, STE. J
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City | HOUSTON
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State | TX
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Zip | 77081
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Country | US
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Telephone | 346-204-5882
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Fax | 346-204-5697
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Provider Business Mailing Address
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Address Line | 5716 BELLAIRE BVLD, STE. J
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City | HOUSTON
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State | TX
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Zip | 77081
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Country | US
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Telephone | 346-204-5882
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Fax | 346-204-5697
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Authorized Official
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Title or Position | OFFICER
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Name | LORI A DANZY
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Credential |
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Telephone | 346-204-5882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 30245
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License Number State | TX
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