Provider Demographics
NPI:1952545907
Name:MAZZOLINI, ELISABETH ANN (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:ANN
Last Name:MAZZOLINI
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21214 NORTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3373
Mailing Address - Country:US
Mailing Address - Phone:832-912-3773
Mailing Address - Fax:
Practice Address - Street 1:21214 NORTHWEST FWY
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-3373
Practice Address - Country:US
Practice Address - Phone:832-912-3773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist