Provider Demographics
NPI:1518563758
Name:JOSEPH, SUNIL (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:SUNIL
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 AUTUMN SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4649
Mailing Address - Country:US
Mailing Address - Phone:281-546-4566
Mailing Address - Fax:
Practice Address - Street 1:3505 CENTER ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536-5078
Practice Address - Country:US
Practice Address - Phone:281-476-3461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52948183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist