Provider Demographics
NPI:1942801808
Name:TABOH, ERICA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:TABOH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:TEKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3526 SCHUMANN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2856
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:831 HIGHWAY 59 S
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-4873
Practice Address - Country:US
Practice Address - Phone:281-592-2636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55496183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist