Provider Demographics
NPI:1194080416
Name:SCOTT, COLLETTE (RPH)
Entity type:Individual
Prefix:MRS
First Name:COLLETTE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2918 MISSION VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3427
Mailing Address - Country:US
Mailing Address - Phone:281-438-9641
Mailing Address - Fax:
Practice Address - Street 1:2918 MISSION VALLEY DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3427
Practice Address - Country:US
Practice Address - Phone:281-438-9641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34813183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist