Provider Demographics
NPI:1033708045
Name:ABEL, MARK RUSSELL (CPHT)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:RUSSELL
Last Name:ABEL
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1014 OAK GLEN DR
Mailing Address - Street 2:
Mailing Address - City:WILLIS
Mailing Address - State:TX
Mailing Address - Zip Code:77378-5743
Mailing Address - Country:US
Mailing Address - Phone:979-676-1859
Mailing Address - Fax:
Practice Address - Street 1:1702 11TH ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-3723
Practice Address - Country:US
Practice Address - Phone:936-291-0302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician