Individual
KELLY GRAGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 OYSTER CREEK DR, LAKE JACKSON, TX 77566-4157
(979) 297-3254
(979) 297-9012
Mailing address
117 OYSTER CREEK DR, LAKE JACKSON, TX 77566-4157
(979) 297-3254
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
104392
TX
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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