Provider Demographics
NPI:1235725433
Name:ZACHARIAH, GINA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:
Last Name:ZACHARIAH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4716 ALLIANCE BLVD STE 280
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5381
Mailing Address - Country:US
Mailing Address - Phone:469-814-5780
Mailing Address - Fax:
Practice Address - Street 1:4716 ALLIANCE BLVD STE 280
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5381
Practice Address - Country:US
Practice Address - Phone:469-814-5780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54275183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1568889160OtherPHARMACY
1568889160OtherNONE