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General NPI Number Information
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NPI Number | 1619520350
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Entity Type | Individual
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Provider Name | GINNY DANELLE LANDRY RPH
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Gender | Female
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Dates
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Enumeration Date | 07/22/2019
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 5605 COLLEYVILLE BLVD
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City | COLLEYVILLE
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State | TX
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Zip | 76034-6022
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Country | US
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Telephone | 817-577-5030
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Fax |
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Provider Business Mailing Address
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Address Line | 112 BLAIRSTONE PNES
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City | GRAPEVINE
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State | TX
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Zip | 76051-8250
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Country | US
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Telephone | 972-998-1979
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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 | 39555
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License Number State | TX
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