Provider Demographics
NPI:1629350335
Name:GEORGE, JIMS OOMMEN (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:JIMS
Middle Name:OOMMEN
Last Name:GEORGE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 E END BLVD N
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-3605
Mailing Address - Country:US
Mailing Address - Phone:903-923-0605
Mailing Address - Fax:903-923-0661
Practice Address - Street 1:309 E END BLVD N
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-3605
Practice Address - Country:US
Practice Address - Phone:903-923-0605
Practice Address - Fax:903-923-0661
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50423183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist