Immunovax

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

27662 Issued in TX

Legal business name

IMMUNOVAX

Practice address

14655 Northwest Fwy Ste 101
Houston, TX 77040-4032

Phone

(832) 460-9003

Fax

(713) 939-1221

NPI assigned

Dec 2, 2011

Organization subpart

No

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

Authorized official

Name

Michael Adams

Title

Owner

Phone

(832) 460-9003

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Travelvax Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410912000000",
    "number": "1417225673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14655 NORTHWEST FWY STE 101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770404032",
            "telephone_number": "832-460-9003",
            "fax_number": "713-939-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14655 NORTHWEST FWY STE 101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770404032",
            "telephone_number": "832-460-9003",
            "fax_number": "713-939-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMUNOVAX",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2014-09-17",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-460-9003"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "27662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2132868",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Travelvax Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Imole Healthcare Inc
• Imole Transportation LLC
• Impact 360

• 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 17, 2014; 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.