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NPI Code Detail

MEDICARE: GINNY DANELLE LANDRY RPH

MEDICARE: GINNY DANELLE LANDRY RPH
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
1183500000XPharmacist39555TX

General Provider Information

NPI Number : 1619520350
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINNY DANELLE LANDRY RPH
Provider Business Mailing Address
First Line : 112 BLAIRSTONE PNES
Second Line :
City : GRAPEVINE
State : TX
Zip : 76051-8250
Country : US
Telephone Number : 972-998-1979
Fax Number :
Provider Business Practice Location Address
First Line : 5605 COLLEYVILLE BLVD
Second Line :
City : COLLEYVILLE
State : TX
Zip : 76034-6022
Country : US
Telephone Number : 817-577-5030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2019
Last Update Date : 07/22/2019

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Directions to “ GINNY DANELLE LANDRY RPH” Practice Location

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