Provider Demographics
NPI:1518942259
Name:PUBLIC EXPRESS INC
Entity Type:Organization
Organization Name:PUBLIC EXPRESS INC
Other - Org Name:PINEY POINT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARENE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-461-5151
Mailing Address - Street 1:2532 FONDREN RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2308
Mailing Address - Country:US
Mailing Address - Phone:713-782-6212
Mailing Address - Fax:713-782-2001
Practice Address - Street 1:2532 FONDREN RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2308
Practice Address - Country:US
Practice Address - Phone:713-782-6212
Practice Address - Fax:713-782-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
TX163533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2103916OtherPK
TX091448301Medicaid
TX144224Medicaid
TX091448301Medicaid
4591295Medicare UPIN