Individual
KIM GERARD MOUTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4131 LAKE VISTA CIR, MISSOURI CITY, TX 77459-5031
(281) 468-1078
Mailing address
4131 LAKE VISTA CIR, MISSOURI CITY, TX 77459-5031
(281) 468-1078
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
28881
TX
Other
Enumeration date
07/06/2017
Last updated
07/21/2022
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