Individual
BOUTAMINA GENDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4015 WHEAT HARVEST LN, KATY, TX 77494-6740
(082) 449-7405
Mailing address
4015 WHEAT HARVEST LN, KATY, TX 77494-6740
(508) 244-9740
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
65817
TX
Other
Enumeration date
12/13/2020
Last updated
12/13/2020
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