Provider Demographics
NPI:1598351926
Name:GERLAND, ELLEN (RPH)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:GERLAND
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 1:14100 RANCH ROAD 12
Mailing Address - Street 2:
Mailing Address - City:WIMBERLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78676-5354
Mailing Address - Country:US
Mailing Address - Phone:512-847-5109
Mailing Address - Fax:
Practice Address - Street 1:14100 RANCH ROAD 12
Practice Address - Street 2:
Practice Address - City:WIMBERLEY
Practice Address - State:TX
Practice Address - Zip Code:78676-5354
Practice Address - Country:US
Practice Address - Phone:512-847-5109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-20
Last Update Date:2020-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25203183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist