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General NPI Number Information
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NPI Number | 1265268296
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Entity Type | Individual
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Provider Name | MR. GIFTIN JOSEPH JAMES
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Gender | Male
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 7501 SAN DARIO AVE
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City | LAREDO
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State | TX
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Zip | 78045-7207
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Country | US
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Telephone | 956-722-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 9114 MCPHERSON RD APT 804
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City | LAREDO
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State | TX
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Zip | 78045-6507
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 71730
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License Number State | TX
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