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General NPI Number Information
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NPI Number | 1366044299
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Entity Type | Individual
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Provider Name | EVELYN OMOZUSI ABHULIMEN DR
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Gender | Female
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 133 ARKANSAS BLVD
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City | TEXARKANA
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State | AR
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Zip | 71854-1963
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Country | US
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Telephone | 870-773-7872
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Fax |
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Provider Business Mailing Address
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Address Line | 29 TULIP DR
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City | TEXARKANA
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State | TX
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Zip | 75503-2257
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Country | US
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Telephone | 501-246-0394
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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 | PD11406
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License Number State | AR
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