Provider Demographics
NPI:1407220536
Name:ALOMBAH, ATANGA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ATANGA
Middle Name:
Last Name:ALOMBAH
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 1:4503 W PIONEER DR APT 1301
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-3852
Mailing Address - Country:US
Mailing Address - Phone:603-864-9185
Mailing Address - Fax:
Practice Address - Street 1:9440 MARSH LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-4924
Practice Address - Country:US
Practice Address - Phone:469-341-1548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist