Provider Demographics
NPI:1881923662
Name:RENDON, RAUL DEMETRIO (PHARM D, RPH)
Entity type:Individual
Prefix:DR
First Name:RAUL
Middle Name:DEMETRIO
Last Name:RENDON
Suffix:
Gender:M
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 GARTH RD
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-2425
Mailing Address - Country:US
Mailing Address - Phone:281-427-7126
Mailing Address - Fax:
Practice Address - Street 1:2000 GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-2425
Practice Address - Country:US
Practice Address - Phone:281-427-7126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist