Provider Demographics
NPI:1437574324
Name:GREGG, JOHN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:GREGG
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 1:4200 TRANQUILITY LN
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-9768
Mailing Address - Country:US
Mailing Address - Phone:508-837-9565
Mailing Address - Fax:972-608-2933
Practice Address - Street 1:5425 W SPRING CREEK PKWY STE 190
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4341
Practice Address - Country:US
Practice Address - Phone:214-291-5087
Practice Address - Fax:972-608-2933
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37589183500000X
TX54421183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist