Provider Demographics
NPI:1689859308
Name:ABUYEDEBUBINIGISITI, RESSAH J
Entity Type:Individual
Prefix:DR
First Name:RESSAH
Middle Name:J
Last Name:ABUYEDEBUBINIGISITI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:KWENDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:705 KINGSWAY SUITE 1124
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840
Mailing Address - Country:US
Mailing Address - Phone:430-205-0114
Mailing Address - Fax:
Practice Address - Street 1:2341 EAST MAIN ST WALGREENS
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852
Practice Address - Country:US
Practice Address - Phone:800-879-4471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-31
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15602183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist