Provider Demographics
NPI:1609103001
Name:ASHLEY, COLLEEN G (RPH)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:G
Last Name:ASHLEY
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 1:2204 SOUTHMORE AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502-1420
Mailing Address - Country:US
Mailing Address - Phone:713-473-8267
Mailing Address - Fax:
Practice Address - Street 1:2204 SOUTHMORE AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-1420
Practice Address - Country:US
Practice Address - Phone:713-473-8267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39132183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist