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NPI Code Detail

MEDICARE: JORGE LUIS GREGORISCH PHARMD

MEDICARE:   JORGE LUIS GREGORISCH  PHARMD
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
1183500000XPharmacist41702TX

General Provider Information

NPI Number : 1922619501
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORGE LUIS GREGORISCH PHARMD
Provider Business Mailing Address
First Line : 2323 W ILLINOIS AVE
Second Line :
City : DALLAS
State : TX
Zip : 75224-1637
Country : US
Telephone Number : 214-331-5466
Fax Number : 214-467-4417
Provider Business Practice Location Address
First Line : 2323 W ILLINOIS AVE
Second Line :
City : DALLAS
State : TX
Zip : 75224-1637
Country : US
Telephone Number : 214-331-5466
Fax Number : 214-467-4417
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2020
Last Update Date : 08/16/2020

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Directions to “ JORGE LUIS GREGORISCH PHARMD” Practice Location

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