Provider Demographics
NPI:1841695160
Name:HIGHTOWER, NIRVANA EDSTINE (RPH)
Entity type:Individual
Prefix:
First Name:NIRVANA
Middle Name:EDSTINE
Last Name:HIGHTOWER
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 1:1150 BUNKER HILL RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-6208
Mailing Address - Country:US
Mailing Address - Phone:713-576-2052
Mailing Address - Fax:
Practice Address - Street 1:1150 BUNKER HILL RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6208
Practice Address - Country:US
Practice Address - Phone:713-576-2052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31893183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist