=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518419886
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RX PROFESSIONALS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/02/2016
-----------------------------------------------------
Last Update Date | 06/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3201 MALCOLM X BLVD
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75215-2430
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-396-9790
-----------------------------------------------------
Fax | 214-785-6361
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3201 MALCOLM X BLVD
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75215-2430
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 143-969-7902
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING OFFICER
-----------------------------------------------------
Name | SANJAY PATEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 214-396-9790
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 31073
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------