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NPI Code Detail

MEDICARE: WHITNEY BROOKE BATES DOCTOR OF PHARMACY

MEDICARE: WHITNEY BROOKE BATES DOCTOR OF PHARMACY
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
1183500000XPharmacist46847TX

General Provider Information

NPI Number : 1922318260
Entity Type Code : Individual
Provider Name (Legal Business Name) : WHITNEY BROOKE BATES DOCTOR OF PHARMACY
Provider Business Mailing Address
First Line : 29822 BUFFALO CANYON DR
Second Line :
City : SPRING
State : TX
Zip : 77386-3182
Country : US
Telephone Number : 281-719-5351
Fax Number :
Provider Business Practice Location Address
First Line : 420 N FRAZIER ST
Second Line :
City : CONROE
State : TX
Zip : 77301-2882
Country : US
Telephone Number : 936-494-0424
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2010
Last Update Date : 10/20/2010

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