Provider Demographics
NPI:1376871319
Name:FASE, SOPHIA ALVIAR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:ALVIAR
Last Name:FASE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SOPHIA
Other - Middle Name:MARIE
Other - Last Name:ALVIAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2950 OLD SPANISH TRL
Mailing Address - Street 2:APT 232
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2227
Mailing Address - Country:US
Mailing Address - Phone:269-599-9978
Mailing Address - Fax:
Practice Address - Street 1:51 DIXIE DR
Practice Address - Street 2:
Practice Address - City:CLUTE
Practice Address - State:TX
Practice Address - Zip Code:77531-5147
Practice Address - Country:US
Practice Address - Phone:979-265-2517
Practice Address - Fax:979-265-7397
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47345183500000X
MI5302036076183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist