Provider Demographics
NPI:1194456210
Name:PELZEL, CONNOR JOHN (PHARM D)
Entity Type:Individual
Prefix:
First Name:CONNOR
Middle Name:JOHN
Last Name:PELZEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240-3501
Mailing Address - Country:US
Mailing Address - Phone:940-668-7384
Mailing Address - Fax:
Practice Address - Street 1:1201 OLIVE ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-3501
Practice Address - Country:US
Practice Address - Phone:940-668-7384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70195183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist