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General NPI Number Information
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NPI Number | 1669796801
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Entity Type | Individual
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Provider Name | KWAME YIADOM PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 590 MEDICAL CENTER ROAD
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City | FORT CAVAZOS
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State | TX
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Zip | 76544
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Country | US
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Telephone | 254-288-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 305 WROUGHT IRON DR
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City | HARKER HEIGHTS
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State | TX
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Zip | 76548-7495
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Country | US
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Telephone | 254-419-1029
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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 | PH233354
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License Number State | MA
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