Provider Demographics
NPI:1295947869
Name:MAXCARE
Entity type:Organization
Organization Name:MAXCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-451-8100
Mailing Address - Street 1:11410 EAST FWY # I-10
Mailing Address - Street 2:SUITE 164
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-1976
Mailing Address - Country:US
Mailing Address - Phone:713-451-8100
Mailing Address - Fax:
Practice Address - Street 1:11410 EAST FWY # I-10
Practice Address - Street 2:SUITE 164
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-1976
Practice Address - Country:US
Practice Address - Phone:713-451-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX241753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy