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General NPI Number Information
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NPI Number | 1881638534
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Entity Type | Individual
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Provider Name | GEORGE KEVIN GARDNER RPH
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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 | 02/20/2017
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Provider Practice Location Address
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Address Line | 1748 N GREENVILLE AVE
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City | RICHARDSON
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State | TX
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Zip | 75081-1808
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Country | US
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Telephone | 214-502-8958
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Fax |
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Provider Business Mailing Address
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Address Line | 1429 SHERRYE DR
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City | PLANO
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State | TX
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Zip | 75074-4425
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Country | US
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Telephone | 214-502-8958
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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 | 28050
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302033222
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PD09056
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License Number State | AR
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12224
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License Number State | NE
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Taxonomy #5
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17564
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License Number State | LA
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Taxonomy #6
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 013146
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License Number State | KY
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