MEDICARE: KRYSTIAN VOLAIR 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	61149	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578134482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRYSTIAN VOLAIR RPH

Provider Business Mailing Address
First Line	:	8106 HUSH HEIGHTS DR
Second Line	:
City	:	ROSHARON
State	:	TX
Zip	:	77583
Country	:	US
Telephone Number	:	832-438-9050
Fax Number	:

Provider Business Practice Location Address
First Line	:	2646 S LOOP W STE 330
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2773
Country	:	US
Telephone Number	:	713-661-5711
Fax Number	:

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

Provider Enumeration Date	:	07/02/2021
Last Update Date	:	07/02/2021

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