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General NPI Number Information
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NPI Number | 1831719798
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Entity Type | Individual
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Provider Name | NAFE SAMUEL PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 4388 SUNBELT DR
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City | ADDISON
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State | TX
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Zip | 75001-5611
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Country | US
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Telephone | 972-362-4151
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Fax |
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Provider Business Mailing Address
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Address Line | 1619 W SHADY GROVE RD
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City | IRVING
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State | TX
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Zip | 75060-3771
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Country | US
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Telephone |
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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 | 66053
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License Number State | TX
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