Provider Demographics
NPI:1164023453
Name:GEURIN, MATTHEW RICHMOND (PHARMD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:RICHMOND
Last Name:GEURIN
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 1:319 S BRIGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-5742
Mailing Address - Country:US
Mailing Address - Phone:314-973-0951
Mailing Address - Fax:
Practice Address - Street 1:12300 LAKE JUNE RD
Practice Address - Street 2:
Practice Address - City:BALCH SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75180-1636
Practice Address - Country:US
Practice Address - Phone:972-286-0180
Practice Address - Fax:972-286-7770
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010026497183500000X
TX54901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist