=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134976871
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIKA NICOLE BROWN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2024
-----------------------------------------------------
Last Update Date | 05/01/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18220 TX-249 PHARMACY DEPARTMENT
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77070
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-737-0461
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1503 WENTWORTH ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77004-5642
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-305-5462
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835X0200X
-----------------------------------------------------
Taxonomy Name | Oncology Pharmacist
-----------------------------------------------------
License Number | 44421
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------