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General NPI Number Information
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NPI Number | 1700407350
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Entity Type | Individual
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Provider Name | EMAD BANOUB
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Gender | Male
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 7304 LOUETTA RD
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City | SPRING
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State | TX
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Zip | 77379-7234
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Country | US
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Telephone | 281-379-1317
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Fax | 281-379-6275
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Provider Business Mailing Address
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Address Line | 1514 ENNIS JOSLIN RD APT 626
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City | CORPUS CHRISTI
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State | TX
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Zip | 78412-2112
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Country | US
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Telephone | 469-831-7002
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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 | 66273
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License Number State | TX
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