Provider Demographics
NPI:1811518814
Name:TALEIO INCORPORATED
Entity type:Organization
Organization Name:TALEIO INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:DAMONICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:832-889-7872
Mailing Address - Street 1:1116 RADIO LN STE 202
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-3953
Mailing Address - Country:US
Mailing Address - Phone:832-889-7872
Mailing Address - Fax:
Practice Address - Street 1:1116 RADIO LN STE 202
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-3953
Practice Address - Country:US
Practice Address - Phone:832-451-6340
Practice Address - Fax:832-451-6668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-30
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150329Medicaid