Provider Demographics
NPI:1205187341
Name:TRIPPETT, MARY KATHLEEN (RPH)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHLEEN
Last Name:TRIPPETT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 LAKE POINTE PKWY
Mailing Address - Street 2:ST. 308
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4095
Mailing Address - Country:US
Mailing Address - Phone:281-325-6645
Mailing Address - Fax:281-325-6655
Practice Address - Street 1:1327 LAKE POINTE PKWY
Practice Address - Street 2:ST. 308
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4095
Practice Address - Country:US
Practice Address - Phone:281-325-6645
Practice Address - Fax:281-325-6655
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30565183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist