Provider Demographics
NPI:1033448733
Name:ALANIS, JACQUELINE SUSANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:SUSANN
Last Name:ALANIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4807 TEN SLEEP LN
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-8101
Mailing Address - Country:US
Mailing Address - Phone:713-261-6985
Mailing Address - Fax:713-941-0319
Practice Address - Street 1:390 EDGEBROOK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-2102
Practice Address - Country:US
Practice Address - Phone:713-943-1810
Practice Address - Fax:713-941-0319
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40833183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist