Provider Demographics
NPI:1245824630
Name:IGLEHART, ANGELIA GAIL
Entity type:Individual
Prefix:
First Name:ANGELIA
Middle Name:GAIL
Last Name:IGLEHART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3327 KNOLL WEST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-3651
Mailing Address - Country:US
Mailing Address - Phone:281-795-5455
Mailing Address - Fax:
Practice Address - Street 1:1289 N POST OAK RD STE 130
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7253
Practice Address - Country:US
Practice Address - Phone:713-680-1325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty