Provider Demographics
NPI:1235501081
Name:VIALLON, PAUL LOUIS V (RPH)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:LOUIS
Last Name:VIALLON
Suffix:V
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 1:32553 BOWIE ST
Mailing Address - Street 2:
Mailing Address - City:WHITE CASTLE
Mailing Address - State:LA
Mailing Address - Zip Code:70788-2503
Mailing Address - Country:US
Mailing Address - Phone:225-545-2277
Mailing Address - Fax:225-545-2903
Practice Address - Street 1:32553 BOWIE ST
Practice Address - Street 2:
Practice Address - City:WHITE CASTLE
Practice Address - State:LA
Practice Address - Zip Code:70788-2503
Practice Address - Country:US
Practice Address - Phone:225-545-2277
Practice Address - Fax:225-545-2903
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA016691183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist