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NPI Code Detail

MEDICARE: BRENDAN GONSALVES PHARM.D.

MEDICARE: BRENDAN GONSALVES PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist55582TX

General Provider Information

NPI Number : 1023411477
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDAN GONSALVES PHARM.D.
Provider Business Mailing Address
First Line : 1226 W GRAND PKWY S
Second Line : APARTMENT 811
City : KATY
State : TX
Zip : 77494-8442
Country : US
Telephone Number : 419-902-3596
Fax Number :
Provider Business Practice Location Address
First Line : 5161 FRANZ RD
Second Line :
City : KATY
State : TX
Zip : 77493-1754
Country : US
Telephone Number : 281-391-3410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2014
Last Update Date : 09/30/2014

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Directions to “ BRENDAN GONSALVES PHARM.D.” Practice Location

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