Provider Demographics
NPI:1508278375
Name:EXPRESS SPECIALTY PHARMACY LLC
Entity Type:Organization
Organization Name:EXPRESS SPECIALTY PHARMACY LLC
Other - Org Name:EXPRESS SPECIALTY PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUONG
Authorized Official - Middle Name:
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-453-7916
Mailing Address - Street 1:5037 B FM 2920
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388
Mailing Address - Country:US
Mailing Address - Phone:281-453-7085
Mailing Address - Fax:832-565-9265
Practice Address - Street 1:5037 B FM 2920
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388
Practice Address - Country:US
Practice Address - Phone:281-453-7085
Practice Address - Fax:832-565-9265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX292793336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145923OtherPK