Provider Demographics
NPI:1598052763
Name:IHEME, SANDRA DABELEMA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:DABELEMA
Last Name:IHEME
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:DABELEMA
Other - Middle Name:SONGO
Other - Last Name:BATUBO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:861 OLD ALICE RD STE 109
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8551
Mailing Address - Country:US
Mailing Address - Phone:956-404-0202
Mailing Address - Fax:956-574-9766
Practice Address - Street 1:861 OLD ALICE RD STE 109
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8551
Practice Address - Country:US
Practice Address - Phone:956-404-0202
Practice Address - Fax:956-574-9766
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47768183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist