Provider Demographics
NPI:1720363153
Name:PICHARDO, JOSMARY ISABEL (PHARM D)
Entity Type:Individual
Prefix:
First Name:JOSMARY
Middle Name:ISABEL
Last Name:PICHARDO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3706 GRAMMERCY PARK DR
Mailing Address - Street 2:APT 214
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-4403
Mailing Address - Country:US
Mailing Address - Phone:201-815-3997
Mailing Address - Fax:
Practice Address - Street 1:6205 WESTCREEK DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-4319
Practice Address - Country:US
Practice Address - Phone:817-263-0962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50784183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist