Provider Demographics
NPI:1356941330
Name:ELFENBEIN, SCOTT PHILIP
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:PHILIP
Last Name:ELFENBEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 COIT RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-5903
Mailing Address - Country:US
Mailing Address - Phone:972-985-3081
Mailing Address - Fax:
Practice Address - Street 1:6000 COIT RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-5903
Practice Address - Country:US
Practice Address - Phone:972-985-3081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist