Organization
MED VALT PHARMACY LLC
Active
Other names
MED VALT PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN ABOBO PHARMD. MBA (CEO/PRESIDENT)
(713) 349-9882
Entity
Organization
Contact information
Practice address
11811 FM 1960 RD W STE 110, HOUSTON, TX 77065-3828
(713) 349-9882
(713) 349-9887
Mailing address
2656 S LOOP W STE 103, HOUSTON, TX 77054-5632
(713) 349-9882
(713) 349-9887
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
27004
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149061
—
TX
01
—
2124920
PK
—
Enumeration date
10/26/2009
Last updated
07/03/2024
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