Provider Demographics
NPI:1194136465
Name:GALLUCCI, GIUSEPPE (RPH)
Entity type:Individual
Prefix:
First Name:GIUSEPPE
Middle Name:
Last Name:GALLUCCI
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 1:5107 VANDELIA ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-8827
Mailing Address - Country:US
Mailing Address - Phone:214-317-0448
Mailing Address - Fax:
Practice Address - Street 1:5107 VANDELIA ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-8827
Practice Address - Country:US
Practice Address - Phone:214-317-0448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38341183500000X
LA16027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist