Provider Demographics
NPI:1154954006
Name:ABEL, KENNETH W
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:W
Last Name:ABEL
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 1:7809 KNOB HILL AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-2701
Mailing Address - Country:US
Mailing Address - Phone:281-479-6750
Mailing Address - Fax:
Practice Address - Street 1:2619 RED BLUFF RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77506-5270
Practice Address - Country:US
Practice Address - Phone:713-475-0939
Practice Address - Fax:713-477-8514
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX335961835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist