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NPI Code Detail

MEDICARE: DIPU GEORGE PHARMD

MEDICARE: DIPU GEORGE 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
1183500000XPharmacist61300TX

General Provider Information

NPI Number : 1063938983
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIPU GEORGE PHARMD
Provider Business Mailing Address
First Line : 3355 LAKEWAY LN
Second Line :
City : PEARLAND
State : TX
Zip : 77584-8413
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1088 W MAIN ST
Second Line :
City : LEAGUE CITY
State : TX
Zip : 77573-2022
Country : US
Telephone Number : 281-332-3445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2017
Last Update Date : 08/22/2017

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Directions to “ DIPU GEORGE PHARMD” Practice Location

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