Healthcare Provider Details

I. General information

NPI: 1366473308
Provider Name (Legal Business Name): SONYA R. WILMER PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 HOLCOMBE BLVD 119/CSSL
HOUSTON TX
77030-4211
US

IV. Provider business mailing address

2002 HOLCOMBE BLVD 119/CSSL
HOUSTON TX
77030-4211
US

V. Phone/Fax

Practice location:
  • Phone: 713-791-1414
  • Fax: 713-794-7064
Mailing address:
  • Phone: 713-791-1414
  • Fax: 713-794-7064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number43690
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: