Provider Demographics
NPI:1205183241
Name:FRAZIER, CHELSEA (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 SAMUELS AVE
Mailing Address - Street 2:8406
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-2399
Mailing Address - Country:US
Mailing Address - Phone:512-971-8988
Mailing Address - Fax:
Practice Address - Street 1:4520 WESTERN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76137-2635
Practice Address - Country:US
Practice Address - Phone:817-514-8063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist