Provider Demographics
NPI:1891166732
Name:KEERIKATTU, LYNN ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ANN
Last Name:KEERIKATTU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MEYERLAND PLAZA MALL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-1611
Mailing Address - Country:US
Mailing Address - Phone:713-292-0031
Mailing Address - Fax:
Practice Address - Street 1:300 MEYERLAND PLAZA MALL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-1611
Practice Address - Country:US
Practice Address - Phone:713-292-0031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist