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General NPI Number Information
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NPI Number | 1881350809
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Entity Type | Individual
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Provider Name | KRYSTAL KYMBERLIE HOLMES PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/14/2021
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Last Update Date | 11/14/2021
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Provider Practice Location Address
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Address Line | 3080 COLLEGE ST
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City | BEAUMONT
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State | TX
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Zip | 77701-4606
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Country | US
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Telephone | 409-926-7915
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Fax |
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Provider Business Mailing Address
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Address Line | 8849 PINEWOOD DR APT 2201
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City | PORT ARTHUR
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State | TX
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Zip | 77640-1144
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Country | US
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Telephone | 313-269-2357
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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 | 67574
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 23621
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License Number State | IA
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