Organization
MED VALT PHARMACY LLC
Active
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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