Provider Demographics
NPI:1013382324
Name:KOBAYASHI, KAYTA (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAYTA
Middle Name:
Last Name:KOBAYASHI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3518 BRADFORD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1330
Mailing Address - Country:US
Mailing Address - Phone:650-200-7644
Mailing Address - Fax:713-797-5788
Practice Address - Street 1:1333 MOURSUND ST
Practice Address - Street 2:TIRR PHARMACY
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3405
Practice Address - Country:US
Practice Address - Phone:713-797-5287
Practice Address - Fax:713-797-5788
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-11
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX531511835P0018X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care