Healthcare Provider Details

I. General information

NPI: 1326764184
Provider Name (Legal Business Name): BENJAMIN SEKYERE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8555 FERGUSON RD
DALLAS TX
75228-5343
US

IV. Provider business mailing address

2902 CEDAR BROOK DR
GARLAND TX
75040-9051
US

V. Phone/Fax

Practice location:
  • Phone: 214-320-0892
  • Fax:
Mailing address:
  • Phone: 469-450-2258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number41015
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: