MEDICARE: ROBERT PERSAUD

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	53330	TX

General Provider Information

NPI Number	:	1598198616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT PERSAUD

Provider Business Mailing Address
First Line	:	PO BOX 27294
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77227-7294
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1352 W 43RD ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-4206
Country	:	US
Telephone Number	:	713-681-0821
Fax Number	:	713-681-8062

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

Provider Enumeration Date	:	08/13/2013
Last Update Date	:	06/15/2026

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