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General NPI Number Information
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NPI Number | 1942604582
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Entity Type | Individual
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Provider Name | DEOGRATIUS KABYEMERA
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Gender | Male
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Dates
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Enumeration Date | 10/10/2014
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Last Update Date | 10/10/2014
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Provider Practice Location Address
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Address Line | 1521 N COCKRELL HILL RD
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City | DALLAS
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State | TX
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Zip | 75211-1315
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Country | US
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Telephone | 214-330-3120
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Fax |
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Provider Business Mailing Address
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Address Line | 118 WESTONGATE WAY
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City | CARY
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State | NC
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Zip | 27513
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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 | 51536
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License Number State | TX
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