Provider Demographics
NPI:1376145417
Name:CASTRO, JEFF RUSSELL PINSON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:RUSSELL PINSON
Last Name:CASTRO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 CASTLEMAN COVE DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-3480
Mailing Address - Country:US
Mailing Address - Phone:469-688-0094
Mailing Address - Fax:
Practice Address - Street 1:1977 N COLLINS BLVD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3526
Practice Address - Country:US
Practice Address - Phone:469-204-6962
Practice Address - Fax:469-204-6964
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66349183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty