Provider Demographics
NPI:1881077766
Name:CLEVELAND, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:CLEVELAND
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 1:15655 CYPRESS WOODS MED DR
Mailing Address - Street 2:SUITE #150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15655 CYPRESS WOODS MED DR
Practice Address - Street 2:SUITE #150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014
Practice Address - Country:US
Practice Address - Phone:713-442-1779
Practice Address - Fax:713-442-1791
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36410183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist