Provider Demographics
NPI:1225614217
Name:GINN, JOSEPH M
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:GINN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 W PARKER RD STE 395
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-8139
Mailing Address - Country:US
Mailing Address - Phone:972-905-5504
Mailing Address - Fax:
Practice Address - Street 1:3304 COIT RD STE 425
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-6145
Practice Address - Country:US
Practice Address - Phone:903-517-5783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist