MEDICARE: VANIA JOY PABELONIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	062331	NY
2	183500000X	Pharmacist	62208	TX

General Provider Information

NPI Number	:	1366991465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANIA JOY PABELONIA

Provider Business Mailing Address
First Line	:	4907 SPRING AVE STE 101
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75210-1316
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4907 SPRING AVE STE 101
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75210-1316
Country	:	US
Telephone Number	:	214-565-8551
Fax Number	:	214-565-8541

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2016
Last Update Date	:	08/25/2022

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Directions to “ VANIA JOY PABELONIA ” Practice Location

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