Provider Demographics
NPI:1770810640
Name:CHEVALIER, QUENTIN JAMES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:QUENTIN
Middle Name:JAMES
Last Name:CHEVALIER
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 1:2600 COLE AVE APT 415
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-4051
Mailing Address - Country:US
Mailing Address - Phone:504-915-5964
Mailing Address - Fax:
Practice Address - Street 1:2060 S BUCKNER BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-1823
Practice Address - Country:US
Practice Address - Phone:214-398-8754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist