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General NPI Number Information
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NPI Number | 1306587621
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Entity Type | Organization
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Legal Business Name | REUSSI HEALTHCARE PLLC
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Dates
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Enumeration Date | 04/02/2022
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 5501 INDEPENDENCE PKWY STE 311
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City | PLANO
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State | TX
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Zip | 75023-5468
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Country | US
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Telephone | 832-755-3078
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Fax |
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Provider Business Mailing Address
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Address Line | 8055 WINDROSE AVE APT 3121
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City | PLANO
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State | TX
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Zip | 75024-0268
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Country | US
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Telephone | 832-755-3078
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | DR. MODUPE FAMODIMU
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Credential | PHARMD
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Telephone | 832-755-3078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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