Kristopher Ryan Desormeaux, PHARMD
Individual provider Active NPI Pharmacist · Atascocita, TX
NPI 1609138361 · NPPES record last updated Jun 8, 2012
Key facts
- NPI
- 1609138361
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 42370 (TX)
- Practice address
- 6931 FM 1960 Rd E
Atascocita, TX 77346-2705 - Phone
- (281) 318-2238
- NPI assigned
- Jun 8, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42370 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 42370 | TX | Yes |
Addresses
Primary practice location
6931 FM 1960 Rd E
Atascocita, TX 77346-2705
Mailing address
6931 FM 1960 Rd E
Atascocita, TX 77346-2705
Phone (281) 318-2238
Other providers in Atascocita, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.