MEDICARE: JACQUELINE SUSANN ALANIS PHARMD

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	40833	TX

General Provider Information

NPI Number	:	1033448733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE SUSANN ALANIS PHARMD

Provider Business Mailing Address
First Line	:	4807 TEN SLEEP LN
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-8101
Country	:	US
Telephone Number	:	713-261-6985
Fax Number	:	713-941-0319

Provider Business Practice Location Address
First Line	:	390 EDGEBROOK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77034-2102
Country	:	US
Telephone Number	:	713-943-1810
Fax Number	:	713-941-0319

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

Provider Enumeration Date	:	12/09/2009
Last Update Date	:	12/09/2009

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