MEDICARE: FREDERICK KWAME ARTHUR

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	41797	TX

General Provider Information

NPI Number	:	1710591904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FREDERICK KWAME ARTHUR

Provider Business Mailing Address
First Line	:	13133 VETERANS MEMORIAL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-1903
Country	:	US
Telephone Number	:	281-440-7456
Fax Number	:	281-537-6877

Provider Business Practice Location Address
First Line	:	13133 VETERANS MEMORIAL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77014-1903
Country	:	US
Telephone Number	:	281-440-7456
Fax Number	:	281-537-6877

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

Provider Enumeration Date	:	09/03/2020
Last Update Date	:	09/03/2020

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