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NPI Code Detail

MEDICARE: DR. CHISOM BEVERLY JINADU PHARMD

MEDICARE: DR. CHISOM BEVERLY JINADU PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist61566TX

General Provider Information

NPI Number : 1407468754
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHISOM BEVERLY JINADU PHARMD
Provider Business Mailing Address
First Line : 7425 LA VISTA DR APT 2235
Second Line :
City : DALLAS
State : TX
Zip : 75214-4476
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 451 FM 548
Second Line :
City : FORNEY
State : TX
Zip : 75126-6288
Country : US
Telephone Number : 972-552-1633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2020
Last Update Date : 08/18/2020

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Directions to “ DR. CHISOM BEVERLY JINADU PHARMD” Practice Location

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