MEDICARE: MR. MARSHALL EDWIN ADAMS RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	23928	TX

General Provider Information

NPI Number	:	1023346541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARSHALL EDWIN ADAMS RPH

Provider Business Mailing Address
First Line	:	1501 MARYLAND ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-1861
Country	:	US
Telephone Number	:	713-522-6813
Fax Number	:

Provider Business Practice Location Address
First Line	:	5560 WESLAYAN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-1942
Country	:	US
Telephone Number	:	713-667-9349
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2009
Last Update Date	:	11/20/2009

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