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NPI Code Detail

MEDICARE: KAVEN LY

MEDICARE: KAVEN LY
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
1183500000XPharmacist59380TX

General Provider Information

NPI Number : 1851836605
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAVEN LY
Provider Business Mailing Address
First Line : 3040 COLLEGE PARK DRIVE
Second Line :
City : WOODLANDS
State : TX
Zip : 77358
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3040 COLLEGE PARK DR
Second Line :
City : THE WOODLANDS
State : TX
Zip : 77384-8002
Country : US
Telephone Number : 936-271-0755
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2017
Last Update Date : 01/04/2017

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Directions to “ KAVEN LY ” Practice Location

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