Basic Information
| Provider Information | |||||||||
| NPI: | 1144501180 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EWER | ||||||||
| FirstName: | CHAD | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARMD, RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4808 FAIRMONT PKWY | ||||||||
| Address2: | #177 | ||||||||
| City: | PASADENA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775053722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2816150674 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 500 MAXEY RD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770135036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133304552 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2011 | ||||||||
| LastUpdateDate: | 09/05/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 49176 | TX | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.