Provider Demographics
NPI:1487258562
Name:JOY, SNEHA JIJO
Entity type:Individual
Prefix:
First Name:SNEHA
Middle Name:JIJO
Last Name:JOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-2043
Mailing Address - Country:US
Mailing Address - Phone:972-932-6585
Mailing Address - Fax:972-932-8954
Practice Address - Street 1:102 E MULBERRY ST
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-2043
Practice Address - Country:US
Practice Address - Phone:972-932-6585
Practice Address - Fax:972-932-8954
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43103183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist