Individual
CHRISTIAN LYLE ANDREW MACTAVISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 W PARKWOOD AVE, FRIENDSWOOD, TX 77546-5405
(281) 996-9971
(281) 996-9980
Mailing address
701 W PARKWOOD AVE, FRIENDSWOOD, TX 77546-5405
(281) 996-9971
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
310666
TX
183700000X
Pharmacy Technician
Primary
310666
TX
Other
Enumeration date
04/14/2021
Last updated
04/14/2021
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