=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255013330
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAMILY AND CHILD GUIDANCE CENTERS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2023
-----------------------------------------------------
Last Update Date | 08/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8915 HARRY HINES BLVD STE P
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75235-1717
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-548-9484
-----------------------------------------------------
Fax | 855-571-3693
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8915 HARRY HINES BLVD STE P
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75235-1717
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-548-9484
-----------------------------------------------------
Fax | 855-571-3693
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACY DIRECTOR
-----------------------------------------------------
Name | EMILY L VIOLA
-----------------------------------------------------
Credential | PHARM D
-----------------------------------------------------
Telephone | 972-548-9484
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------