Provider Demographics
NPI:1023537743
Name:PRO MED RX
Entity Type:Organization
Organization Name:PRO MED RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:DANZY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-204-5882
Mailing Address - Street 1:5716 BELLAIRE BVLD, STE. J
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081
Mailing Address - Country:US
Mailing Address - Phone:346-204-5882
Mailing Address - Fax:346-204-5697
Practice Address - Street 1:5716 BELLAIRE BLDV, STE. J
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081
Practice Address - Country:US
Practice Address - Phone:346-204-5882
Practice Address - Fax:346-204-5697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30245333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy