1033530100 NPI number — MRS. ELIZABETH B. ABEBE RPH, PHARMD

Table of content: MRS. ELIZABETH B. ABEBE RPH, PHARMD (NPI 1033530100)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033530100 NPI number — MRS. ELIZABETH B. ABEBE RPH, PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABEBE
Provider First Name:
ELIZABETH
Provider Middle Name:
B.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RPH, PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033530100
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6200 SAVOY
Provider Second Line Business Mailing Address:
STE 540
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77036-3338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-778-1300
Provider Business Mailing Address Fax Number:
713-778-0827

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1414 S. FRAZIER
Provider Second Line Business Practice Location Address:
STE 5
Provider Business Practice Location Address City Name:
CONROE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77301-4475
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
936-494-2455
Provider Business Practice Location Address Fax Number:
936-434-2456
Provider Enumeration Date:
12/17/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  43169 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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