MEDICARE: MRS. ELIZABETH B. ABEBE RPH, PHARMD

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	43169	TX

General Provider Information

NPI Number	:	1033530100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH B. ABEBE RPH, PHARMD

Provider Business Mailing Address
First Line	:	6200 SAVOY
Second Line	:	STE 540
City	:	HOUSTON
State	:	TX
Zip	:	77036-3338
Country	:	US
Telephone Number	:	713-778-1300
Fax Number	:	713-778-0827

Provider Business Practice Location Address
First Line	:	1414 S. FRAZIER
Second Line	:	STE 5
City	:	CONROE
State	:	TX
Zip	:	77301-4475
Country	:	US
Telephone Number	:	936-494-2455
Fax Number	:	936-434-2456

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

Provider Enumeration Date	:	12/17/2013
Last Update Date	:	12/17/2013

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