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General NPI Number Information
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NPI Number | 1225484645
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Entity Type | Organization
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Legal Business Name | SECURERX HEALTHCARE, LLC
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 05/05/2016
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Provider Practice Location Address
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Address Line | 1214 N POST OAK RD STE 150
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City | HOUSTON
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State | TX
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Zip | 77055-7251
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Country | US
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Telephone | 832-404-6755
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Fax | 832-529-1500
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Provider Business Mailing Address
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Address Line | 1862 W. BITTERS, STE. 200
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City | SAN ANTONIO
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State | TX
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Zip | 78248
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Country | US
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Telephone | 210-529-7076
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Fax | 210-568-4147
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Authorized Official
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Title or Position | EXECUTIVE ASSISTANT
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Name | DOMINIQUE PHILLIPS
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Credential |
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Telephone | 210-529-7076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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