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NPI Code Detail

MEDICARE: DR. RENI JOHN JACOB PHARM. D

MEDICARE: DR. RENI JOHN JACOB PHARM. D
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
1183500000XPharmacist47817TX

General Provider Information

NPI Number : 1730419334
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RENI JOHN JACOB PHARM. D
Provider Business Mailing Address
First Line : WALGREENS
Second Line : 388 UVALDE RD
City : HOUSTON
State : TX
Zip : 77015-2213
Country : US
Telephone Number : 713-455-9944
Fax Number :
Provider Business Practice Location Address
First Line : WALGREENS
Second Line : 388 UVALDE RD
City : HOUSTON
State : TX
Zip : 77015-2213
Country : US
Telephone Number : 713-455-9944
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2010
Last Update Date : 01/04/2010

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