Provider Demographics
NPI:1952387250
Name:HOUSER, RALFE DANA (RPH)
Entity type:Individual
Prefix:MR
First Name:RALFE
Middle Name:DANA
Last Name:HOUSER
Suffix:
Gender:M
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:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:TX
Mailing Address - Zip Code:78384-0176
Mailing Address - Country:US
Mailing Address - Phone:361-516-6455
Mailing Address - Fax:
Practice Address - Street 1:730 FORRESTAL ST/BLD 375
Practice Address - Street 2:NAS KINGSVILLE PHARMACY
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363
Practice Address - Country:US
Practice Address - Phone:361-516-6455
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28291183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist