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General NPI Number Information
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NPI Number | 1124312996
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Entity Type | Individual
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Provider Name | JEFF MCCLUSKY RPH
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Gender | Male
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Dates
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Enumeration Date | 06/08/2011
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 1220 HOLCOMBE BLVD
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City | HOUSTON
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State | TX
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Zip | 77030-4004
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Country | US
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Telephone | 832-729-2197
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Fax |
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Provider Business Mailing Address
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Address Line | 21331 WINDING PATH WAY
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City | RICHMOND
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State | TX
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Zip | 77406-3603
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Country | US
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Telephone | 832-492-9266
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 34969
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License Number State | TX
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