=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548621378
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DOROTHY SAMSON RPH.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2016
-----------------------------------------------------
Last Update Date | 01/06/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6121 HILLCROFT ST STE J
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77081-1007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 183-296-8421
-----------------------------------------------------
Fax | 832-968-4376
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6121 HILLCROFT ST STE J
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77081-1007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-968-4211
-----------------------------------------------------
Fax | 832-968-4376
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 32884
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------