Individual
ANUM ABID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
1021 W UNIVERSITY AVE STE B3, GEORGETOWN, TX 78628-5339
(512) 869-3170
Mailing address
1021 W UNIVERSITY AVE STE B3, GEORGETOWN, TX 78628-5339
(512) 869-3170
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
63516
TX
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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