Provider Demographics
NPI:1194182113
Name:MAFHH EXPRESS SERVICES LLC
Entity Type:Organization
Organization Name:MAFHH EXPRESS SERVICES LLC
Other - Org Name:TEXAS INFUSION PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-636-2290
Mailing Address - Street 1:9100 SOUTHWEST FWY STE 207
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1531
Mailing Address - Country:US
Mailing Address - Phone:713-636-2290
Mailing Address - Fax:713-636-2092
Practice Address - Street 1:9100 SOUTHWEST FWY STE 207
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1531
Practice Address - Country:US
Practice Address - Phone:713-636-2290
Practice Address - Fax:713-636-2092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30577333600000X
3336C0003X, 3336C0004X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148362Medicaid
2171082OtherPK