Provider Demographics
NPI:1336488543
Name:FITZGERALD, KRISTY (PHARMD)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:FITZGERALD
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 1:2702 SHELBY DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-4997
Mailing Address - Country:US
Mailing Address - Phone:281-881-6968
Mailing Address - Fax:
Practice Address - Street 1:2702 SHELBY DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4997
Practice Address - Country:US
Practice Address - Phone:281-881-6968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41685183500000X
WAPH0004868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist