Provider Demographics
NPI:1093042616
Name:NWOKORO, STANLEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:
Last Name:NWOKORO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6505 COVE HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-5540
Mailing Address - Country:US
Mailing Address - Phone:817-557-4650
Mailing Address - Fax:
Practice Address - Street 1:5600 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1808
Practice Address - Country:US
Practice Address - Phone:817-465-5048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42018183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist