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General NPI Number Information
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NPI Number | 1215257654
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Entity Type | Individual
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Provider Name | EUNICE BOLAJI SADIPE-IDONIJE R.PH.
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Gender | Female
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Dates
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Enumeration Date | 06/08/2010
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Last Update Date | 09/26/2017
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Provider Practice Location Address
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Address Line | 2000 N PLANO RD STE 113
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City | RICHARDSON
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State | TX
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Zip | 75082-4402
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Country | US
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Telephone | 214-792-9682
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Fax |
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Provider Business Mailing Address
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Address Line | 3646 CANYON OAKS DR
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City | CARROLLTON
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State | TX
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Zip | 75007-2779
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Country | US
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Telephone | 214-213-6881
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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 | 30542
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License Number State | TX
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