Provider Demographics
NPI:1912224403
Name:MARTINS, BUKOLA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BUKOLA
Middle Name:
Last Name:MARTINS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:SUWEBAT
Other - Middle Name:
Other - Last Name:MARTINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 720786
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77272-0786
Mailing Address - Country:US
Mailing Address - Phone:281-866-5252
Mailing Address - Fax:
Practice Address - Street 1:10498 FOUNTAIN LAKE DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-0786
Practice Address - Country:US
Practice Address - Phone:281-866-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist