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General NPI Number Information
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NPI Number | 1245825777
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Entity Type | Individual
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Provider Name | FLORENCE TITECK MBAH
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Gender | Female
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Dates
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Enumeration Date | 03/05/2021
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Last Update Date | 03/05/2021
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Provider Practice Location Address
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Address Line | 2391 S WAYSIDE DR
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City | HOUSTON
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State | TX
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Zip | 77023-3910
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Country | US
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Telephone | 713-300-3662
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Fax | 713-300-3654
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Provider Business Mailing Address
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Address Line | 10800 KIPP WAY DR APT 1501
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City | HOUSTON
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State | TX
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Zip | 77099-2699
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Country | US
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Telephone | 832-630-2619
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 63680
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License Number State | TX
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