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General NPI Number Information
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NPI Number | 1437642873
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Entity Type | Individual
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Provider Name | JONTIA GENTRY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | 21106 KUYKENDAHL RD
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City | SPRING
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State | TX
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Zip | 77379
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Country | US
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Telephone | 281-355-6325
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Fax |
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Provider Business Mailing Address
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Address Line | 21106 KUYKENDAHL RD
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City | SPRING
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State | TX
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Zip | 77379-3300
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Country | US
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Telephone |
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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 | 33139
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License Number State | TX
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