Healthcare Provider Details

I. General information

NPI: 1952849077
Provider Name (Legal Business Name): CONNIE GELINEAU PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6020 W PARKER RD STE 270
PLANO TX
75093-0007
US

IV. Provider business mailing address

6020 W PARKER RD STE 270
PLANO TX
75093-0007
US

V. Phone/Fax

Practice location:
  • Phone: 972-378-4107
  • Fax: 855-675-9368
Mailing address:
  • Phone: 972-378-4107
  • Fax: 855-675-9368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00009070
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number63637
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18154
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23159
License Number StateIA
# 5
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number45214
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: