Provider Demographics
NPI:1750614178
Name:GAILARD, PAUL D (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:GAILARD
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 1:5019 SAN ADAN AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1835
Mailing Address - Country:US
Mailing Address - Phone:505-839-9165
Mailing Address - Fax:
Practice Address - Street 1:5019 SAN ADAN AVE NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1835
Practice Address - Country:US
Practice Address - Phone:505-839-9165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM42121835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy