Provider Demographics
NPI:1619262904
Name:ADAMS, CELESTE LOUISE
Entity Type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:LOUISE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10704 GALSWORTHY LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78739-1752
Mailing Address - Country:US
Mailing Address - Phone:720-883-2125
Mailing Address - Fax:512-651-0095
Practice Address - Street 1:3702 RANCH ROAD 620 S
Practice Address - Street 2:
Practice Address - City:BEE CAVES
Practice Address - State:TX
Practice Address - Zip Code:78738-6304
Practice Address - Country:US
Practice Address - Phone:512-651-0095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39967183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist