Provider Demographics
NPI:1457689408
Name:NJAKO, SIMON N (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SIMON
Middle Name:N
Last Name:NJAKO
Suffix:
Gender:M
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 1:25675 OVERLOOK PKWY
Mailing Address - Street 2:# 2504
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-2508
Mailing Address - Country:US
Mailing Address - Phone:402-708-3570
Mailing Address - Fax:
Practice Address - Street 1:9080 MARBACH RD
Practice Address - Street 2:WALGREENS.
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245
Practice Address - Country:US
Practice Address - Phone:210-673-3082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47740183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist