Provider Demographics
NPI:1477149318
Name:FULBRIGHT, JENNIFER (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:FULBRIGHT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19019 GREENVIEW GLEN DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-0052
Mailing Address - Country:US
Mailing Address - Phone:713-254-6971
Mailing Address - Fax:
Practice Address - Street 1:21660 KINGSLAND BLVD STE 600
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2541
Practice Address - Country:US
Practice Address - Phone:832-437-2216
Practice Address - Fax:832-437-2396
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40230183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist