Provider Demographics
NPI:1558699421
Name:GIRGIRO, KONGIT
Entity Type:Individual
Prefix:
First Name:KONGIT
Middle Name:
Last Name:GIRGIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 GREGORY CT
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-5840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:832-725-6085
Practice Address - Street 1:3317 MONTROSE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-3931
Practice Address - Country:US
Practice Address - Phone:713-520-7777
Practice Address - Fax:713-520-6049
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41972183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist