Protex Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PROTEX PHARMACY LLC

Practice address

1540 Kenforest Dr
Missouri City, TX 77489-2165

Phone

(713) 632-3305

NPI assigned

Jul 14, 2015

Organization subpart

No

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

Authorized official

Name

Dele Agbogun, MALE

Title

President

Phone

(713) 632-3305

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• N/A Other name

Locations

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436832000000",
    "number": "1760866339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 KENFOREST DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774892165",
            "telephone_number": "713-632-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 KENFOREST DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774892165",
            "telephone_number": "713-632-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROTEX PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-14",
        "last_updated": "2015-07-14",
        "status": "A",
        "authorized_official_last_name": "AGBOGUN",
        "authorized_official_first_name": "DELE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-632-3305",
        "authorized_official_credential": "MALE"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY",
            "identifier": "00",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "N/A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Providers in Missouri City, 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 Jul 14, 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.