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General NPI Number Information
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NPI Number | 1205435195
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Entity Type | Individual
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Provider Name | SCOTT SADLOWSKI
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Gender | Male
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Dates
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Enumeration Date | 10/21/2020
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 12605 I-45 N
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City | WILLIS
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State | TX
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Zip | 77318
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Country | US
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Telephone | 936-890-5060
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Fax |
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Provider Business Mailing Address
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Address Line | 262 W PINES CT
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City | MONTGOMERY
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State | TX
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Zip | 77356-3721
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 53322
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License Number State | TX
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