Provider Demographics
NPI:1134534241
Name:HOUZE, TIFFANY PETRICE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:PETRICE
Last Name:HOUZE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11530 N TRYON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-0459
Mailing Address - Country:US
Mailing Address - Phone:980-428-8133
Mailing Address - Fax:980-428-8132
Practice Address - Street 1:11530 N TRYON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-0459
Practice Address - Country:US
Practice Address - Phone:980-428-8133
Practice Address - Fax:980-428-8132
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17226183500000X
SC10908183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist