MEDICARE: ESKEDAR DICKIE

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
1	183500000X	Pharmacist	38604	TX

General Provider Information

NPI Number	:	1295335750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESKEDAR DICKIE

Provider Business Mailing Address
First Line	:	95 N BERRYLINE CIR
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77381-4817
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3450 CYPRESS CREEK PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77068-3606
Country	:	US
Telephone Number	:	281-440-0741
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2020
Last Update Date	:	10/26/2020

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Directions to “ ESKEDAR DICKIE ” Practice Location

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