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General NPI Number Information
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NPI Number | 1225902182
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Entity Type | Individual
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Provider Name | JACQUES P LANDRY PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 1 JEFFERSON BARRACKS RD
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City | SAINT LOUIS
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State | MO
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Zip | 63125-4181
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Country | US
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Telephone | 314-652-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 13100 RED CEDAR CIR
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City | OKLAHOMA CITY
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State | OK
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Zip | 73131-1860
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Country | US
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Telephone | 405-202-1958
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 11893
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License Number State | OK
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