Healthcare Provider Details

I. General information

NPI: 1427451178
Provider Name (Legal Business Name): ANTHONY OBUTE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2014
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 GULF FWY
HOUSTON TX
77017-7023
US

IV. Provider business mailing address

9301 GULF FWY
HOUSTON TX
77017-7023
US

V. Phone/Fax

Practice location:
  • Phone: 832-834-3312
  • Fax: 832-834-3325
Mailing address:
  • Phone: 832-834-3312
  • Fax: 832-834-3325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number54534
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: