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General NPI Number Information
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NPI Number | 1811773179
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Entity Type | Individual
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Provider Name | CAMILLE NORA ADDISON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/04/2023
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Last Update Date | 09/04/2023
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Provider Practice Location Address
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Address Line | 6420 GASTON AVE
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City | DALLAS
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State | TX
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Zip | 75214-4022
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Country | US
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Telephone | 469-334-0758
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Fax |
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Provider Business Mailing Address
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Address Line | 7373 VALLEY VIEW LN APT 1116
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City | DALLAS
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State | TX
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Zip | 75240-5550
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Country | US
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Telephone | 913-219-3336
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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 | 73084
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License Number State | TX
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