Provider Demographics
NPI:1639775158
Name:KOWALIS, JANICE ANNETTE
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:ANNETTE
Last Name:KOWALIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JANICE
Other - Middle Name:ANNETTE
Other - Last Name:KOWALIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:20302 MORNING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6617
Mailing Address - Country:US
Mailing Address - Phone:281-701-5669
Mailing Address - Fax:
Practice Address - Street 1:20302 MORNING CREEK DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6617
Practice Address - Country:US
Practice Address - Phone:281-701-5669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist