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General NPI Number Information
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NPI Number | 1962716209
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Entity Type | Individual
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Provider Name | LAWRENCE METUGE EKANEY PD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 09/23/2020
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Provider Practice Location Address
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Address Line | 17826 DAVENPORT RD STE B
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City | DALLAS
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State | TX
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Zip | 75252-5876
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Country | US
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Telephone | 972-467-0173
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Fax |
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Provider Business Mailing Address
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Address Line | 17826 DAVENPORT RD STE B
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City | DALLAS
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State | TX
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Zip | 75252-5876
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Country | US
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Telephone | 469-351-3462
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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 | 51362
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License Number State | TX
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