Provider Demographics
NPI:1902241854
Name:ADAMALEY-JOHNSON, MABEL
Entity Type:Individual
Prefix:
First Name:MABEL
Middle Name:
Last Name:ADAMALEY-JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3726 ABBEYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5903
Mailing Address - Country:US
Mailing Address - Phone:713-502-5569
Mailing Address - Fax:281-412-3758
Practice Address - Street 1:3550 SWINGLE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-3763
Practice Address - Country:US
Practice Address - Phone:713-547-1264
Practice Address - Fax:713-547-1275
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42826183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist