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NPI Code Detail

MEDICARE: MRS. JENNIFER FAJARDO

MEDICARE: MRS. JENNIFER FAJARDO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist49549TX

General Provider Information

NPI Number : 1114203528
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER FAJARDO
Provider Business Mailing Address
First Line : 3015 LENORA SPRINGS DR
Second Line :
City : SPRING
State : TX
Zip : 77386-3239
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1403 FM 1960 RD W
Second Line :
City : HOUSTON
State : TX
Zip : 77090-3303
Country : US
Telephone Number : 281-444-1201
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2011
Last Update Date : 10/30/2011

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Directions to “ MRS. JENNIFER FAJARDO ” Practice Location

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