Provider Demographics
NPI:1396304572
Name:HARTIN, CURTIS (RPH)
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:
Last Name:HARTIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27222 FULSHEAR BEND DR APT 1133
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1197
Mailing Address - Country:US
Mailing Address - Phone:864-430-0906
Mailing Address - Fax:
Practice Address - Street 1:1330 ENCLAVE PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-2577
Practice Address - Country:US
Practice Address - Phone:864-430-0906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22860183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist