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General NPI Number Information
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NPI Number | 1053216374
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Entity Type | Individual
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Provider Name | CHARLINE VANESSA YANZEU TSOKGNA NGNABEUYE
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Gender | Female
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 4203 S CARRIER PKWY
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-3203
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Country | US
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Telephone | 972-642-3910
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Fax |
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Provider Business Mailing Address
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Address Line | 7068 ALCALA
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City | GRAND PRAIRIE
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State | TX
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Zip | 75054-6759
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Country | US
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Telephone | 945-388-5230
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 77263
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License Number State | TX
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