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General NPI Number Information
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NPI Number | 1336191410
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Entity Type | Individual
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Provider Name | RUSSELL JAMES PELZEL RPH.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 1340 N HIGHWAY 377 STE 100
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City | PILOT POINT
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State | TX
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Zip | 76258-3762
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Country | US
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Telephone | 940-686-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 125 COUNTY ROAD 286
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City | COLLINSVILLE
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State | TX
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Zip | 76233-2314
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Country | US
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Telephone | 903-436-1359
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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 | 31328
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License Number State | TX
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