MEDICARE: DR. FRED R CURTISS PHD, RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	37697	CA

General Provider Information

NPI Number	:	1033113311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRED R CURTISS PHD, RPH

Provider Business Mailing Address
First Line	:	14825 SEA AIR LN
Second Line	:
City	:	PORT ARANSAS
State	:	TX
Zip	:	78373-4962
Country	:	US
Telephone Number	:	361-749-0482
Fax Number	:	361-749-0482

Provider Business Practice Location Address
First Line	:	14825 SEA AIR LN
Second Line	:
City	:	PORT ARANSAS
State	:	TX
Zip	:	78373-4962
Country	:	US
Telephone Number	:	361-749-0482
Fax Number	:	361-749-0482

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	07/08/2007

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