Provider Demographics
NPI:1629679527
Name:TABE, MARGARET EWUBE
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:EWUBE
Last Name:TABE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 SHADDOCK PARK LN
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5666
Mailing Address - Country:US
Mailing Address - Phone:770-315-9139
Mailing Address - Fax:
Practice Address - Street 1:1501 BUCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5304
Practice Address - Country:US
Practice Address - Phone:972-235-9391
Practice Address - Fax:972-235-9393
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51097183500000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No333600000XSuppliersPharmacy