Healthcare Provider Details

I. General information

NPI: 1053535013
Provider Name (Legal Business Name): MARIA THERESA DIXON HELBACH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA THERESA DIXON PHARMD

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 W 3RD ST SUITE 501
TEMPE AZ
85281-2831
US

IV. Provider business mailing address

550 W 19TH ST
TEMPE AZ
85281-6525
US

V. Phone/Fax

Practice location:
  • Phone: 480-317-6780
  • Fax:
Mailing address:
  • Phone: 480-495-3358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202205883
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14644
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: