Provider Demographics
NPI:1982050738
Name:GORE, CATHERINE LORRAINE (RPH)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LORRAINE
Last Name:GORE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:MORRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:13114 BRISTOL BERRY DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3817
Mailing Address - Country:US
Mailing Address - Phone:229-343-6103
Mailing Address - Fax:
Practice Address - Street 1:21515 TOMBALL PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1647
Practice Address - Country:US
Practice Address - Phone:281-379-2861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51095183500000X
GA017409183500000X
MEPR1602183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist