MEDICARE: EXPRESS RX LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336S0011X	Specialty Pharmacy
3	3336C0003X	Community/Retail Pharmacy	24133	TX

General Provider Information

NPI Number	:	1043221633
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPRESS RX LLC

Provider Business Mailing Address
First Line	:	3535 BRIARPARK DR
Second Line	:	STE 110
City	:	HOUSTON
State	:	TX
Zip	:	77042-5245
Country	:	US
Telephone Number	:	281-619-2079
Fax Number	:	281-619-2085

Provider Business Practice Location Address
First Line	:	3535 BRIARPARK DR
Second Line	:	STE 110
City	:	HOUSTON
State	:	TX
Zip	:	77042-5245
Country	:	US
Telephone Number	:	281-619-2079
Fax Number	:	281-619-2085

Authorized Official
Title or Position	:	CEO
Name	:	JP MONTEVERDE
Credential	:
Telephone Number	:	903-223-5229

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	03/30/2023

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Directions to “EXPRESS RX LLC ” Practice Location

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