Healthcare Provider Details

I. General information

NPI: 1306581731
Provider Name (Legal Business Name): MARY CATES HOUSTON BEVIER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2022
Last Update Date: 04/29/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 VEAZEY DR
BUTNER NC
27509-1668
US

IV. Provider business mailing address

1029 GALLIVANT WAY
WAKE FOREST NC
27587-8226
US

V. Phone/Fax

Practice location:
  • Phone: 919-764-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24313
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: