Provider Demographics
NPI:1730417817
Name:MICHALK, GRACE ELIZABETH (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:ELIZABETH
Last Name:MICHALK
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6380 FOLSOM DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-7265
Mailing Address - Country:US
Mailing Address - Phone:800-880-9902
Mailing Address - Fax:
Practice Address - Street 1:6380 FOLSOM DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-7265
Practice Address - Country:US
Practice Address - Phone:800-880-9902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-30
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46891183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist