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General NPI Number Information
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NPI Number | 1932923893
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Entity Type | Individual
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Provider Name | EDWIN WONTUMI ASIEDU PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 9937 GARLAND RD
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City | DALLAS
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State | TX
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Zip | 75218-3259
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Country | US
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Telephone | 214-328-4971
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Fax |
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Provider Business Mailing Address
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Address Line | 1413 SHADOW BROOK TRL
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City | GARLAND
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State | TX
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Zip | 75043-1782
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Country | US
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Telephone | 469-756-6977
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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 | 74124
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License Number State | TX
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