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General NPI Number Information
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NPI Number | 1326082082
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Entity Type | Individual
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Provider Name | ALBERT AVINOAM GROSSMAN R.PH. M.S.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2310 LBJ FREEWAY SUITE 100
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City | DALLAS
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State | TX
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Zip | 75234-7335
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Country | US
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Telephone | 972-929-7105
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Fax | 800-965-7105
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Provider Business Mailing Address
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Address Line | 1404 COMMERCE DR
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City | PLANO
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State | TX
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Zip | 75093-2638
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Country | US
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Telephone | 972-964-9804
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Fax | 972-964-9804
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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 | 33666
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License Number State | TX
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