MEDICARE: MRS. DEMETRA SIGERS BUCHANAN 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	36351	TX

General Provider Information

NPI Number	:	1225366230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEMETRA SIGERS BUCHANAN RPH

Provider Business Mailing Address
First Line	:	2622 BRAZOS RIDGE DR
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-8928
Country	:	US
Telephone Number	:	281-633-8219
Fax Number	:

Provider Business Practice Location Address
First Line	:	9150 S DAIRY ASHFORD ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77099-1218
Country	:	US
Telephone Number	:	281-498-3734
Fax Number	:

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

Provider Enumeration Date	:	12/02/2009
Last Update Date	:	12/02/2009

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