Individual
ALTA BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
20168 EVA ST, MONTGOMERY, TX 77356-2006
(936) 449-7167
Mailing address
20168 EVA ST, MONTGOMERY, TX 77356-2006
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
58958
TX
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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