Healthcare Provider Details

I. General information

NPI: 1528260148
Provider Name (Legal Business Name): NATALIE ELIZABETH CLARKSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2346 GOLDEN SHORES LN
LEAGUE CITY TX
77573-0700
US

IV. Provider business mailing address

2346 GOLDEN SHORES LN
LEAGUE CITY TX
77573-0700
US

V. Phone/Fax

Practice location:
  • Phone: 334-663-6498
  • Fax:
Mailing address:
  • Phone: 334-663-6498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number7636
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: