Provider Demographics
NPI:1689986333
Name:COMEAUX, KENNETH ROBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:ROBERT
Last Name:COMEAUX
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3755 ATASCOCITA RD
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-3532
Mailing Address - Country:US
Mailing Address - Phone:281-812-4778
Mailing Address - Fax:281-812-4460
Practice Address - Street 1:3755 ATASCOCITA RD
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-3532
Practice Address - Country:US
Practice Address - Phone:281-812-4778
Practice Address - Fax:281-812-4460
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44059183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist