Provider Demographics
NPI:1154996452
Name:VALENTI, CHARLES THOMAS (RPH)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:THOMAS
Last Name:VALENTI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4282 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:TX
Mailing Address - Zip Code:75032-5809
Mailing Address - Country:US
Mailing Address - Phone:972-722-2040
Mailing Address - Fax:
Practice Address - Street 1:4282 RIDGE RD
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032-5809
Practice Address - Country:US
Practice Address - Phone:972-722-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist