Provider Demographics
NPI:1861103152
Name:LIEBL, MICHAEL GARRY (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GARRY
Last Name:LIEBL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7550 GREENBRIAR DR # RB6-126
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4508
Mailing Address - Country:US
Mailing Address - Phone:346-356-1757
Mailing Address - Fax:346-356-1196
Practice Address - Street 1:7550 GREENBRIAR DR # RB6-126
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4508
Practice Address - Country:US
Practice Address - Phone:346-356-1757
Practice Address - Fax:346-356-1196
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX373101835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist