Provider Demographics
NPI:1780689596
Name:SMITH, CARL ANTHONY (RPH)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:ANTHONY
Last Name:SMITH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:1829 OAK LODGE DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-6195
Mailing Address - Country:US
Mailing Address - Phone:281-992-6304
Mailing Address - Fax:281-992-2056
Practice Address - Street 1:7550 OFFICE CITY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77012-4115
Practice Address - Country:US
Practice Address - Phone:713-495-3715
Practice Address - Fax:713-495-3717
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX34326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist