Most Relevant Information
Provider Data
| NPI Number: | 1003404690 |
| Provider Name: | FRED NICHOLS |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 36546 |
Most Important Dates
| Enumeration Date: | 01/08/2021 |
| Last Updated: | 01/08/2021 |
Provider Practice Location
9215 BROADWAY ST STE 113
PEARLAND
TX
775848987
Practice Location Phone/Fax
| Phone: | 2817415825 |
| Fax: |
Provider Mailing Location
9215 BROADWAY ST STE 113
PEARLAND
TX
775848987
Provider Mailing Phone/Fax
| Phone: | 2817415825 |
| Fax: |