Provider Demographics
NPI:1003531013
Name:GROVER, PUJA
Entity type:Individual
Prefix:
First Name:PUJA
Middle Name:
Last Name:GROVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PUJA
Other - Middle Name:
Other - Last Name:GROVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:19411 MAIDENHAIR FERN DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-7992
Mailing Address - Country:US
Mailing Address - Phone:832-654-9965
Mailing Address - Fax:
Practice Address - Street 1:11301 FALLBROOK DR STE 124
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-5312
Practice Address - Country:US
Practice Address - Phone:281-653-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42253183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist