Provider Demographics
NPI:1538755228
Name:SINGH, GURVINDER (PHARMD)
Entity type:Individual
Prefix:
First Name:GURVINDER
Middle Name:
Last Name:SINGH
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 1:202 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-7345
Mailing Address - Country:US
Mailing Address - Phone:409-755-0451
Mailing Address - Fax:409-755-0466
Practice Address - Street 1:202 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:TX
Practice Address - Zip Code:77657-7345
Practice Address - Country:US
Practice Address - Phone:409-755-0451
Practice Address - Fax:409-755-0466
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX465216Medicaid