MEDICARE: MR. CARL ANTHONY SMITH 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	34326	TX

General Provider Information

NPI Number	:	1780689596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARL ANTHONY SMITH RPH

Provider Business Mailing Address
First Line	:	1829 OAK LODGE DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77581-6195
Country	:	US
Telephone Number	:	281-992-6304
Fax Number	:	281-992-2056

Provider Business Practice Location Address
First Line	:	7550 OFFICE CITY DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77012-4115
Country	:	US
Telephone Number	:	713-495-3715
Fax Number	:	713-495-3717

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	08/29/2007

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