Mavis O Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

27514 Issued in TX

Legal business name

MAVIS O PHARMACY LLC

Practice address

10080 Bellaire Blvd Ste 102
Houston, TX 77072-5249

Phone

(281) 498-1161

Fax

(281) 498-1180

NPI assigned

Jun 24, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bayo Adeniyi

Title

Pic

Phone

(281) 498-1161

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mavis O Pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441324800000",
    "number": "1104112366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10080 BELLAIRE BLVD STE 102",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770725249",
            "telephone_number": "281-498-1161",
            "fax_number": "281-498-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10080 BELLAIRE BLVD STE 102",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770725249",
            "telephone_number": "281-498-1161",
            "fax_number": "281-498-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVIS O PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-24",
        "last_updated": "2015-09-04",
        "status": "A",
        "authorized_official_last_name": "ADENIYI",
        "authorized_official_first_name": "BAYO",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "281-498-1161"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "27514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2130938",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mavis O Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mavenva Professionals
• Maverick DME
• Maverick DX LLC
• Mavis Dao O.D. & Associates, PLLC
• Mavis Fujii Mdpa
• Hanna Mavric, DO
• Mavride LLC
• Agnes J Mawa, RN
• Esther Mawa
• Michel E. Mawad, M.D.

• Community/Retail Pharmacy in Houston, TX
• Providers in Houston, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.