Provider Demographics
NPI:1184343634
Name:ANIFOWOSE, BOSE ESTHER (RPH)
Entity type:Individual
Prefix:MS
First Name:BOSE
Middle Name:ESTHER
Last Name:ANIFOWOSE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12411 N RACHLIN CIR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-2819
Mailing Address - Country:US
Mailing Address - Phone:832-661-2725
Mailing Address - Fax:
Practice Address - Street 1:107 W RANKIN RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-6928
Practice Address - Country:US
Practice Address - Phone:281-872-0612
Practice Address - Fax:713-872-0301
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73359183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist