Provider Demographics
NPI:1073199121
Name:OFODILE, JULIEANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIEANN
Middle Name:
Last Name:OFODILE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6717 KINROSS DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-5570
Mailing Address - Country:US
Mailing Address - Phone:817-966-7099
Mailing Address - Fax:
Practice Address - Street 1:6717 KINROSS DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-5570
Practice Address - Country:US
Practice Address - Phone:817-966-7099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist