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NPI Code Detail

MEDICARE: JUDITH JOSEPHINE PRUZZO R.PH.

MEDICARE: JUDITH JOSEPHINE PRUZZO R.PH.
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
1183500000XPharmacist20328TX
2183500000XPharmacist7991OK
3183500000XPharmacist27828MO

General Provider Information

NPI Number : 1891923603
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDITH JOSEPHINE PRUZZO R.PH.
Provider Business Mailing Address
First Line : 4303 SHADOW GLEN DR
Second Line :
City : DALLAS
State : TX
Zip : 75287-6828
Country : US
Telephone Number : 972-931-8760
Fax Number : 972-931-2685
Provider Business Practice Location Address
First Line : 4303 SHADOW GLEN DR
Second Line :
City : DALLAS
State : TX
Zip : 75287-6828
Country : US
Telephone Number : 972-931-8760
Fax Number : 972-931-2685
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2009
Last Update Date : 06/30/2009

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Directions to “ JUDITH JOSEPHINE PRUZZO R.PH.” Practice Location

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