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NPI Code Detail

MEDICARE: JOHN MBEPO PHARMD

MEDICARE: JOHN MBEPO 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
1183500000XPharmacist50850TX

General Provider Information

NPI Number : 1881970176
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN MBEPO PHARMD
Provider Business Mailing Address
First Line : 4200 NORTHERN CROSS BLVD
Second Line : APT 3307
City : HALTOM CITY
State : TX
Zip : 76137-6400
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4520 WESTERN CENTER BLVD
Second Line :
City : HALTOM CITY
State : TX
Zip : 76137-2635
Country : US
Telephone Number : 817-514-8064
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2011
Last Update Date : 10/31/2011

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