Provider Demographics
NPI:1366101990
Name:PALLETT, DAVID J (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:PALLETT
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 1:1209 LAKEWAY DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-2286
Mailing Address - Country:US
Mailing Address - Phone:469-682-3355
Mailing Address - Fax:
Practice Address - Street 1:7777 FOREST LN STE B-A80
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2571
Practice Address - Country:US
Practice Address - Phone:972-383-7020
Practice Address - Fax:844-608-1633
Is Sole Proprietor?:No
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43390183500000X
TX31268183500000X
MST-100179183500000X
LAPST.024064183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist