MEDICARE: EBERE RACHAEL ENEBELI PHARMD

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
1	183500000X	Pharmacist	49109	TX

General Provider Information

NPI Number	:	1750985800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EBERE RACHAEL ENEBELI PHARMD

Provider Business Mailing Address
First Line	:	740 S GREENVILLE AVE
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75081-4112
Country	:	US
Telephone Number	:	469-418-9919
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 N FIELD ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-1662
Country	:	US
Telephone Number	:	214-468-8732
Fax Number	:	214-468-8834

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2020
Last Update Date	:	11/29/2020

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Directions to “ EBERE RACHAEL ENEBELI PHARMD” Practice Location

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