Provider Demographics
NPI:1225366230
Name:BUCHANAN, DEMETRA SIGERS (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DEMETRA
Middle Name:SIGERS
Last Name:BUCHANAN
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 1:2622 BRAZOS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-8928
Mailing Address - Country:US
Mailing Address - Phone:281-633-8219
Mailing Address - Fax:
Practice Address - Street 1:9150 S DAIRY ASHFORD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-1218
Practice Address - Country:US
Practice Address - Phone:281-498-3734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist