Provider Demographics
NPI:1669697066
Name:PEUGH, GILBERTA JEAN (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:GILBERTA
Middle Name:JEAN
Last Name:PEUGH
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 1:1220 TURTLEPOINT CT.
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2774
Mailing Address - Country:US
Mailing Address - Phone:972-296-9608
Mailing Address - Fax:972-709-3178
Practice Address - Street 1:3555 W WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3461
Practice Address - Country:US
Practice Address - Phone:972-780-3433
Practice Address - Fax:970-709-3178
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38322183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist