Provider Demographics
NPI:1811225014
Name:PEERY, JIHAD AUGUSTA
Entity Type:Individual
Prefix:
First Name:JIHAD
Middle Name:AUGUSTA
Last Name:PEERY
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 1:1001 LOOP 274
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-3094
Mailing Address - Country:US
Mailing Address - Phone:979-849-2347
Mailing Address - Fax:979-849-0875
Practice Address - Street 1:1001 LOOP 274
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-3094
Practice Address - Country:US
Practice Address - Phone:979-849-2347
Practice Address - Fax:979-849-0875
Is Sole Proprietor?:No
Enumeration Date:2009-11-27
Last Update Date:2009-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist