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General NPI Number Information
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NPI Number | 1962006197
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Entity Type | Individual
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Provider Name | NELSON T AWONDO
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Gender | Male
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Dates
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Enumeration Date | 11/29/2020
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Last Update Date | 06/21/2025
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Provider Practice Location Address
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Address Line | 400 ROSALIND REDFERN GROVER PKWY
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City | MIDLAND
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State | TX
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Zip | 79701-5846
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Country | US
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Telephone | 432-211-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 3110 MEARNS CT
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City | MIDLAND
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State | TX
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Zip | 79705-2753
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Country | US
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Telephone | 706-254-5213
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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 | 63426
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License Number State | TX
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