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General NPI Number Information
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NPI Number | 1669071874
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Entity Type | Individual
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Provider Name | ELIZABETH THEOPHILOS RPH
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Gender | Female
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Dates
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Enumeration Date | 10/19/2020
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 7201 GRAPEVINE HWY
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-8605
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Country | US
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Telephone | 817-281-8310
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Fax | 817-427-8281
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Provider Business Mailing Address
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Address Line | 7201 GRAPEVINE HWY
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-8605
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Country | US
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Telephone | 817-281-8310
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Fax | 817-427-8281
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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 | 046601
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License Number State | NY
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Taxonomy #2
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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 | 16022
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License Number State | CO
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Taxonomy #3
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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 | 40434
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License Number State | TX
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