Provider Demographics
NPI:1932796570
Name:HAZENSTAB, REEKA (PHARMD)
Entity type:Individual
Prefix:
First Name:REEKA
Middle Name:
Last Name:HAZENSTAB
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:REEKA
Other - Middle Name:
Other - Last Name:BELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2494 BERING DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4938
Mailing Address - Country:US
Mailing Address - Phone:502-794-5018
Mailing Address - Fax:
Practice Address - Street 1:1415 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-2602
Practice Address - Country:US
Practice Address - Phone:713-665-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67993183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist