Provider Demographics
NPI:1649507773
Name:HOLLAND, ROXANNE (RPH)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19639 EASTEX FWY
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3500
Mailing Address - Country:US
Mailing Address - Phone:281-446-1006
Mailing Address - Fax:281-446-4448
Practice Address - Street 1:19639 EASTEX FWY
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3500
Practice Address - Country:US
Practice Address - Phone:281-446-1006
Practice Address - Fax:281-446-4448
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist