MEDICARE: DAVID FREDDIE 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	70248	TX

General Provider Information

NPI Number	:	1568192904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID FREDDIE PHARMD

Provider Business Mailing Address
First Line	:	200 W 20TH ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-2512
Country	:	US
Telephone Number	:	713-861-2161
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W 20TH ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-2512
Country	:	US
Telephone Number	:	713-861-2161
Fax Number	:

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

Provider Enumeration Date	:	06/16/2022
Last Update Date	:	06/16/2022

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Directions to “ DAVID FREDDIE PHARMD” Practice Location

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