MEDICARE: DR. JENNIFER TERESA HOLYK PHARMD

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	43557	TX

General Provider Information

NPI Number	:	1528353414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER TERESA HOLYK PHARMD

Provider Business Mailing Address
First Line	:	13250 NORTHWEST FWY
Second Line	:	T0858
City	:	HOUSTON
State	:	TX
Zip	:	77040-6003
Country	:	US
Telephone Number	:	713-343-2258
Fax Number	:	713-343-2258

Provider Business Practice Location Address
First Line	:	13250 NORTHWEST FWY
Second Line	:	T0858
City	:	HOUSTON
State	:	TX
Zip	:	77040-6003
Country	:	US
Telephone Number	:	713-343-2258
Fax Number	:	713-343-2258

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

Provider Enumeration Date	:	06/18/2011
Last Update Date	:	01/11/2013

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