MEDICARE: CHAMPIONS STRATEGIES 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	26336	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4553118	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1275763187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAMPIONS STRATEGIES INC

Provider Business Mailing Address
First Line	:	6300 RICHMOND AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-5931
Country	:	US
Telephone Number	:	713-782-2900
Fax Number	:	713-782-2916

Provider Business Practice Location Address
First Line	:	6300 RICHMOND AVE STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-5927
Country	:	US
Telephone Number	:	713-782-2900
Fax Number	:	713-782-2916

Authorized Official
Title or Position	:	PIC
Name	:	ABEL DAVILA
Credential	:
Telephone Number	:	713-377-0536

Provider Enumeration Date	:	07/27/2009
Last Update Date	:	11/03/2009

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Directions to “CHAMPIONS STRATEGIES INC ” Practice Location

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