Provider Demographics
NPI:1538474671
Name:BERRY, VERA (RPH)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:BERRY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7405 FM 1960 RD E
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3128
Mailing Address - Country:US
Mailing Address - Phone:281-812-4729
Mailing Address - Fax:281-812-4793
Practice Address - Street 1:7405 FM 1960 RD E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-3128
Practice Address - Country:US
Practice Address - Phone:281-812-4729
Practice Address - Fax:281-812-4793
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32137183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist