MEDICARE: MEDPRUDENT INC.

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	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144590704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDPRUDENT INC.

Provider Business Mailing Address
First Line	:	6335 GULFTON ST STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-1112
Country	:	US
Telephone Number	:	281-867-0400
Fax Number	:	281-867-0042

Provider Business Practice Location Address
First Line	:	6335 GULFTON ST STE 105
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-1112
Country	:	US
Telephone Number	:	281-867-0040
Fax Number	:	281-867-0042

Authorized Official
Title or Position	:	PIC
Name	:	HETTY UMEH
Credential	:
Telephone Number	:	281-867-0040

Provider Enumeration Date	:	01/12/2012
Last Update Date	:	12/30/2020

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Directions to “MEDPRUDENT INC. ” Practice Location

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