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NPI Code Detail

MEDICARE: BINTA IDODO

MEDICARE: BINTA IDODO
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
1183500000XPharmacist42978TX

General Provider Information

NPI Number : 1891426730
Entity Type Code : Individual
Provider Name (Legal Business Name) : BINTA IDODO
Provider Business Mailing Address
First Line : 17 CALLOWAY CT
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-3466
Country : US
Telephone Number : 214-316-2574
Fax Number :
Provider Business Practice Location Address
First Line : 614 W HENDERSON ST
Second Line :
City : CLEBURNE
State : TX
Zip : 76033-4848
Country : US
Telephone Number : 817-645-2419
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2022
Last Update Date : 06/21/2022

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Directions to “ BINTA IDODO ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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