Provider Demographics
NPI:1891412193
Name:EXPRESS MEDICAL SERVICES
Entity Type:Organization
Organization Name:EXPRESS MEDICAL SERVICES
Other - Org Name:EXPRESS MEDICAL SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MODUPE
Authorized Official - Middle Name:ADETUTU
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-701-9729
Mailing Address - Street 1:14007 SEA MYRTLE LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-2095
Mailing Address - Country:US
Mailing Address - Phone:281-701-9729
Mailing Address - Fax:
Practice Address - Street 1:5373 W ALABAMA ST STE 204
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5923
Practice Address - Country:US
Practice Address - Phone:281-612-9990
Practice Address - Fax:949-404-6994
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXPRESS MEDICAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care