Healthcare Provider Details

I. General information

NPI: 1538161690
Provider Name (Legal Business Name): KAMALASANTHI MASILAMANI PHARM.D., CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2005
Last Update Date: 09/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 RINGOLD ST
HOUSTON TX
77088-6368
US

IV. Provider business mailing address

1314 ROMERO DR
PEARLAND TX
77581-5263
US

V. Phone/Fax

Practice location:
  • Phone: 281-260-3375
  • Fax:
Mailing address:
  • Phone: 281-464-9854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number38703
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number12561
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: