Provider Demographics
NPI:1588254015
Name:BOYKIN, DETRA HUBERT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DETRA
Middle Name:HUBERT
Last Name:BOYKIN
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 1:5627 ALDINE BENDER RD STE 7
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77032-4534
Mailing Address - Country:US
Mailing Address - Phone:281-227-1010
Mailing Address - Fax:281-227-1015
Practice Address - Street 1:5627 ALDINE BENDER RD STE 7
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77032-4534
Practice Address - Country:US
Practice Address - Phone:281-227-1010
Practice Address - Fax:281-227-1015
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist