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General NPI Number Information
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NPI Number | 1609475797
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Entity Type | Individual
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Provider Name | DELE BABATUNDE
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Gender | Male
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 1136 W MAIN ST
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City | LEWISVILLE
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State | TX
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Zip | 75067-3469
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Country | US
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Telephone | 469-968-8025
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Fax | 469-968-8026
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Provider Business Mailing Address
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Address Line | 3215 WINDING RIDGE CIR
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City | MANSFIELD
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State | TX
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Zip | 76063-8837
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Country | US
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Telephone | 817-907-7391
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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 | 38868
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License Number State | TX
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