Healthcare Provider Details

I. General information

NPI: 1225634314
Provider Name (Legal Business Name): SOLOMON SEKYERE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SOLOMON ANTWI

II. Dates (important events)

Enumeration Date: 12/05/2020
Last Update Date: 12/05/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 NE LOOP 564
MINEOLA TX
75773-2913
US

IV. Provider business mailing address

11381 SANTA MARIA RD
FRISCO TX
75035-5301
US

V. Phone/Fax

Practice location:
  • Phone: 214-469-6551
  • Fax:
Mailing address:
  • Phone: 214-469-6551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number35151
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: