Provider Demographics
NPI:1871045906
Name:MULVANY, PAUL (RPH PHARMD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:MULVANY
Suffix:
Gender:M
Credentials:RPH PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 GRAPEVINE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-3698
Mailing Address - Country:US
Mailing Address - Phone:469-487-4045
Mailing Address - Fax:
Practice Address - Street 1:5445 LA SIERRA DR
Practice Address - Street 2:STE 202
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4139
Practice Address - Country:US
Practice Address - Phone:469-267-7762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist