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General NPI Number Information
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NPI Number | 1235337189
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Entity Type | Individual
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Provider Name | RUPERT P PULIDO PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 4907 SPRING AVE STE 101
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City | DALLAS
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State | TX
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Zip | 75210-1360
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Country | US
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Telephone | 214-565-8551
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Fax | 214-565-8541
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Provider Business Mailing Address
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Address Line | 4907 SPRING AVE STE 101
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City | DALLAS
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State | TX
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Zip | 75210-1360
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Country | US
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Telephone | 214-565-8551
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Fax | 214-565-8541
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | P5608
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 56338
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License Number State | TX
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