Provider Demographics
NPI:1639602329
Name:WIGGINS ENTERPRISE LLC
Entity Type:Organization
Organization Name:WIGGINS ENTERPRISE LLC
Other - Org Name:XPRESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:LANTSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-541-3300
Mailing Address - Street 1:7555 BELLAIRE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-5055
Mailing Address - Country:US
Mailing Address - Phone:713-541-3300
Mailing Address - Fax:713-541-3301
Practice Address - Street 1:7555 BELLAIRE BLVD STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-5055
Practice Address - Country:US
Practice Address - Phone:713-541-3300
Practice Address - Fax:713-541-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29860333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX29862OtherBOARD OF PHARMACY PERMIT
TX59-03225OtherNCPDP NUMBER