Organization · Type 2 NPI

Dedicated Physicians Group of Texas PLLC

Non-Pharmacy Dispensing Site · Houston, TX

NPI number 1114514296 Active

Practice location

8121 Broadway St
Houston, TX 77061-1340

Call (305) 628-6117 Map

Mailing address

1395 NW 167th St
Miami Gardens, FL 33169-5710

Specialties and licenses

Taxonomy	Code	License
Non-Pharmacy Dispensing Site Primary	332900000X	None listed

Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

3 other providers at this address

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NPI record

NPI: 1114514296
Entity type: Organization (Type 2)
Issued: Dec 23, 2020
Last updated: Dec 23, 2020
Status: Active
Subpart: Yes of Dedicated Physicians Group of Texas PLLC

Other names

Dedicated Senior Medical Center West Corum · doing business as

Authorized official

Mary Chen
Executive Officer
(305) 628-6117

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1114514296

Dedicated Physicians Group of Texas PLLC's National Provider Identifier is 1114514296, issued on Dec 23, 2020. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Houston, TX. The record was last updated on Dec 23, 2020.