Provider Demographics
NPI:1932704491
Name:DE OLIVEIRA, VALINE CLARK (PHARMD)
Entity Type:Individual
Prefix:
First Name:VALINE
Middle Name:CLARK
Last Name:DE OLIVEIRA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 S GESSNER RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-6802
Mailing Address - Country:US
Mailing Address - Phone:713-484-6011
Mailing Address - Fax:
Practice Address - Street 1:7950 S GESSNER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-6802
Practice Address - Country:US
Practice Address - Phone:713-484-6011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47715183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist