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NPI Code Detail

MEDICARE: MR. WILBERT BLUITT

MEDICARE:  MR. WILBERT  BLUITT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist16028TX

General Provider Information

NPI Number : 1033275581
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILBERT BLUITT
Provider Business Mailing Address
First Line : 2809 CEDAR CREST BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75203
Country : US
Telephone Number : 214-941-1258
Fax Number :
Provider Business Practice Location Address
First Line : 2809 CEDAR CREST BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75203-4009
Country : US
Telephone Number : 214-941-1258
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2006
Last Update Date : 07/08/2007

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Directions to “ MR. WILBERT BLUITT ” Practice Location

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