Provider Demographics
NPI:1235424045
Name:BOUJAOUDE, CHARBEL ANTOINE (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHARBEL
Middle Name:ANTOINE
Last Name:BOUJAOUDE
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 1:19955 KATY FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-1019
Mailing Address - Country:US
Mailing Address - Phone:281-492-7906
Mailing Address - Fax:281-492-7906
Practice Address - Street 1:19955 KATY FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1019
Practice Address - Country:US
Practice Address - Phone:281-492-7906
Practice Address - Fax:281-492-7906
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist