Provider Demographics
NPI:1780265694
Name:TRAVELVAX LLC
Entity type:Organization
Organization Name:TRAVELVAX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:832-460-9003
Mailing Address - Street 1:13201 NORTHWEST FWY STE 635
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6249
Mailing Address - Country:US
Mailing Address - Phone:832-460-9003
Mailing Address - Fax:328-478-1988
Practice Address - Street 1:13201 NORTHWEST FWY STE 635
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6249
Practice Address - Country:US
Practice Address - Phone:832-460-9003
Practice Address - Fax:328-478-1988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy