Provider Demographics
NPI:1639408339
Name:MALVEAUX, COLEEN LIZETTE (RPH)
Entity Type:Individual
Prefix:
First Name:COLEEN
Middle Name:LIZETTE
Last Name:MALVEAUX
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 1:2710 SUNNYCREEK LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2793
Mailing Address - Country:US
Mailing Address - Phone:832-607-1517
Mailing Address - Fax:713-436-7319
Practice Address - Street 1:2710 SUNNYCREEK LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2793
Practice Address - Country:US
Practice Address - Phone:832-607-1517
Practice Address - Fax:713-436-7319
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31621183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist