Provider Demographics
NPI:1518296508
Name:DENNIS, KAYLAN M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAYLAN
Middle Name:M
Last Name:DENNIS
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 1:2414 COUNTY ROAD 90 APT 612
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5115
Mailing Address - Country:US
Mailing Address - Phone:504-452-8051
Mailing Address - Fax:
Practice Address - Street 1:2414 COUNTY ROAD 90 APT 612
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5115
Practice Address - Country:US
Practice Address - Phone:504-452-8051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist