Provider Demographics
NPI:1730406638
Name:COLE, PAUL MARK (RPH)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:MARK
Last Name:COLE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 BUSINESS CENTER DR
Mailing Address - Street 2:ATTN: PHARMACY
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2191
Mailing Address - Country:US
Mailing Address - Phone:713-578-6155
Mailing Address - Fax:713-340-0197
Practice Address - Street 1:2805 BUSINESS CENTER DR
Practice Address - Street 2:ATTN: PHARMACY
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2191
Practice Address - Country:US
Practice Address - Phone:713-578-6155
Practice Address - Fax:713-340-0197
Is Sole Proprietor?:No
Enumeration Date:2010-05-01
Last Update Date:2010-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist