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General NPI Number Information
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NPI Number | 1295947869
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Entity Type | Organization
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Legal Business Name | MAXCARE
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11410 EAST FWY # I-10 SUITE 164
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City | HOUSTON
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State | TX
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Zip | 77029-1976
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Country | US
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Telephone | 713-451-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 11410 EAST FWY # I-10 SUITE 164
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City | HOUSTON
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State | TX
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Zip | 77029-1976
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Country | US
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Telephone | 713-451-8100
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES MILLER
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Credential |
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Telephone | 713-451-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 24175
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License Number State | TX
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