Provider Demographics
NPI:1891022166
Name:SMITH-ANDERSON, MARCIA LOETTA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:LOETTA
Last Name:SMITH-ANDERSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MARCIA
Other - Middle Name:LOETTA
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MAIDEN NAME
Mailing Address - Street 1:12610 EASTEN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-2876
Mailing Address - Country:US
Mailing Address - Phone:281-866-9640
Mailing Address - Fax:
Practice Address - Street 1:12610 EASTEN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-2876
Practice Address - Country:US
Practice Address - Phone:713-530-1317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38715183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX38715OtherTEXAS STATE BOARD OF PHARMACY LICENSE
TX1891022166OtherNPI
03796246OtherTEXAS DRIVERS LICENSE NUMBER