Provider Demographics
NPI:1952639049
Name:IDOWU, ITODE N (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:ITODE
Middle Name:N
Last Name:IDOWU
Suffix:
Gender:F
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 1:3120 N FRY RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-6239
Mailing Address - Country:US
Mailing Address - Phone:281-829-5080
Mailing Address - Fax:281-829-5767
Practice Address - Street 1:3120 N FRY RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-6239
Practice Address - Country:US
Practice Address - Phone:281-829-5080
Practice Address - Fax:281-829-5767
Is Sole Proprietor?:No
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43532183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist