Provider Demographics
NPI:1083075345
Name:DMCIS, LLC
Entity type:Organization
Organization Name:DMCIS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FADY
Authorized Official - Middle Name:
Authorized Official - Last Name:ISKANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-968-7946
Mailing Address - Street 1:5703 FULSHEAR PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-2074
Mailing Address - Country:US
Mailing Address - Phone:713-870-6025
Mailing Address - Fax:
Practice Address - Street 1:104 W SEALY ST
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-2339
Practice Address - Country:US
Practice Address - Phone:281-968-7946
Practice Address - Fax:281-968-7946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-15
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX307163336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33508OtherTEXAS STATE BOARD OF PHARMACY