Provider Demographics
NPI:1356673099
Name:JUDIE, ADRIAN D (RPH)
Entity Type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:D
Last Name:JUDIE
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 1:3111 WOODRIDGE DR STE 500
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-2558
Mailing Address - Country:US
Mailing Address - Phone:713-847-0071
Mailing Address - Fax:713-847-0348
Practice Address - Street 1:3111 WOODRIDGE DR STE 500
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-2558
Practice Address - Country:US
Practice Address - Phone:713-847-0071
Practice Address - Fax:713-847-0348
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40167183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist