MEDICARE: MEDICAL PLUS PHARMACY 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	3336C0003X	Community/Retail Pharmacy	25063	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4541288	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1699889683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL PLUS PHARMACY LLC

Provider Business Mailing Address
First Line	:	13529 S POST OAK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-4007
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13529 S POST OAK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-4007
Country	:	US
Telephone Number	:	713-333-8907
Fax Number	:	866-561-5184

Authorized Official
Title or Position	:	MANAGING OFFICER
Name	:	ANA REDDICK
Credential	:
Telephone Number	:	713-333-8927

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	04/28/2009

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Directions to “MEDICAL PLUS PHARMACY LLC ” Practice Location

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