Provider Demographics
NPI:1801492681
Name:KUDA, JAMIE NARENDRA (PHARMD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:NARENDRA
Last Name:KUDA
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 1:11 BRITTANY ROSE PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77375-3105
Mailing Address - Country:US
Mailing Address - Phone:316-518-7014
Mailing Address - Fax:
Practice Address - Street 1:2180 WOODFOREST PKWY N
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77316-6958
Practice Address - Country:US
Practice Address - Phone:936-588-6061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist