Provider Demographics
NPI:1730198821
Name:DAVIS-BRACKINS, GLORIA ELIZABETH (RPH)
Entity type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:ELIZABETH
Last Name:DAVIS-BRACKINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:GLORIA
Other - Middle Name:ELIZABETH
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:2002 HOLCOMBE BLVD
Mailing Address - Street 2:INPATIENT PHARMACY
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4211
Mailing Address - Country:US
Mailing Address - Phone:713-791-1414
Mailing Address - Fax:
Practice Address - Street 1:2002 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4211
Practice Address - Country:US
Practice Address - Phone:713-791-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist