Provider Demographics
NPI:1326816471
Name:OSIDELE, CORDELIA OSATO (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CORDELIA
Middle Name:OSATO
Last Name:OSIDELE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3703 GALVESTON TRL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-6221
Mailing Address - Country:US
Mailing Address - Phone:210-842-8959
Mailing Address - Fax:
Practice Address - Street 1:1003 COLLEGE ST UNIT 100
Practice Address - Street 2:
Practice Address - City:JUNCTION
Practice Address - State:TX
Practice Address - Zip Code:76849-4632
Practice Address - Country:US
Practice Address - Phone:325-770-7676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy