Provider Demographics
NPI:1053547653
Name:MCCANTS, ELLECYA R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ELLECYA
Middle Name:R
Last Name:MCCANTS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4134 S WEBBER DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9415
Mailing Address - Country:US
Mailing Address - Phone:281-489-5670
Mailing Address - Fax:281-489-5671
Practice Address - Street 1:4134 S WEBBER DR
Practice Address - Street 2:SUITE E
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-9415
Practice Address - Country:US
Practice Address - Phone:281-489-5670
Practice Address - Fax:281-489-5671
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40481183500000X, 1835P0018X, 1835P1200X
FL217831835P0018X, 1835P1200X
LA169021835P0018X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy