Provider Demographics
NPI:1629578141
Name:KABAYADONDO, RAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:
Last Name:KABAYADONDO
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 1:2310 DOLAN SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-3360
Mailing Address - Country:US
Mailing Address - Phone:832-277-0783
Mailing Address - Fax:
Practice Address - Street 1:97 OYSTER CREEK DR
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-4464
Practice Address - Country:US
Practice Address - Phone:979-299-0105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist