Provider Demographics
NPI:1518429737
Name:OBI, GABRIEL EBERE (PHARMD)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:EBERE
Last Name:OBI
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 1:7879 ARMOR LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-6766
Mailing Address - Country:US
Mailing Address - Phone:469-235-2362
Mailing Address - Fax:
Practice Address - Street 1:200 US HIGHWAY 80 E
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1656
Practice Address - Country:US
Practice Address - Phone:972-289-5319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX19858667OtherTEXAS ID