Provider Demographics
NPI:1083082952
Name:SANTHOSH, RIJO (RPH)
Entity Type:Individual
Prefix:MR
First Name:RIJO
Middle Name:
Last Name:SANTHOSH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12207 BELL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1626
Mailing Address - Country:US
Mailing Address - Phone:254-592-0122
Mailing Address - Fax:
Practice Address - Street 1:120 N HIGHWAY 171
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70611-5343
Practice Address - Country:US
Practice Address - Phone:337-855-4848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist