Provider Demographics
NPI:1386017440
Name:OMANDI, DENNIS NYAKUNDI (PHRMD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:NYAKUNDI
Last Name:OMANDI
Suffix:
Gender:M
Credentials:PHRMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15759 SCENIC RD
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-5549
Mailing Address - Country:US
Mailing Address - Phone:201-993-3737
Mailing Address - Fax:
Practice Address - Street 1:15759 SCENIC RD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5549
Practice Address - Country:US
Practice Address - Phone:201-993-3737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist