Healthcare Provider Details

I. General information

NPI: 1780689596
Provider Name (Legal Business Name): CARL ANTHONY SMITH RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7550 OFFICE CITY DR
HOUSTON TX
77012-4115
US

IV. Provider business mailing address

1829 OAK LODGE DR
PEARLAND TX
77581-6195
US

V. Phone/Fax

Practice location:
  • Phone: 713-495-3715
  • Fax: 713-495-3717
Mailing address:
  • Phone: 281-992-6304
  • Fax: 281-992-2056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34326
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: