Provider Demographics
NPI:1902878671
Name:ALIBRANDO, VINCENT (RPH)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:
Last Name:ALIBRANDO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14852 JOHNS COR
Mailing Address - Street 2:
Mailing Address - City:ARP
Mailing Address - State:TX
Mailing Address - Zip Code:75750-9414
Mailing Address - Country:US
Mailing Address - Phone:903-859-9592
Mailing Address - Fax:
Practice Address - Street 1:11937 US HIGHWAY 271
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75708-3154
Practice Address - Country:US
Practice Address - Phone:903-877-7088
Practice Address - Fax:903-877-7006
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist