Individual
EBONY N ALFRED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3590 COLLEGE ST, BEAUMONT, TX 77701-4614
(409) 813-8452
(409) 980-5883
Mailing address
3590 COLLEGE ST, BEAUMONT, TX 77701-4614
(409) 813-8452
(409) 980-5883
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225954
PHARMACY TECHNICIAN LICENSE
TX
Enumeration date
01/11/2021
Last updated
01/11/2021
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