Healthcare Provider Details

I. General information

NPI: 1831479393
Provider Name (Legal Business Name): DR. TIMOTHEE WOTONWO VOUFFO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2011
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2619 RED BLUFF RD
PASADENA TX
77506-5230
US

IV. Provider business mailing address

1619 RED BLUFF RD
PASADENA TX
77506-2712
US

V. Phone/Fax

Practice location:
  • Phone: 713-475-0939
  • Fax: 713-477-8514
Mailing address:
  • Phone: 713-475-0939
  • Fax: 713-477-8514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number51333
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: