Provider Demographics
NPI:1215219548
Name:KAPLAN, MITCHELL J (BSPHARM)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:J
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:BSPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5731 INDIGO ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-1119
Mailing Address - Country:US
Mailing Address - Phone:713-771-8189
Mailing Address - Fax:
Practice Address - Street 1:5731 INDIGO ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-1119
Practice Address - Country:US
Practice Address - Phone:713-771-8189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX18832OtherTEXAS STATE BOARD OF PHARMACY LICENSE NUMBER