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Individual

RIYA PAULOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1950 N GOLIAD ST, FATE, TX 75087-7206
(469) 651-6027
Mailing address
202 THATCHER DR, FATE, TX 75189-6007

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
67288
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
67288
TEXAS STATE BOARD OF PHARMACY LICENSE NUMBER ( PHARMACIST)
TX
Enumeration date
08/01/2022
Last updated
08/01/2022
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