Provider Demographics
NPI:1750985800
Name:ENEBELI, EBERE RACHAEL (PHARMD)
Entity type:Individual
Prefix:
First Name:EBERE
Middle Name:RACHAEL
Last Name:ENEBELI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 S GREENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-4112
Mailing Address - Country:US
Mailing Address - Phone:469-418-9919
Mailing Address - Fax:
Practice Address - Street 1:2501 N FIELD ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-1662
Practice Address - Country:US
Practice Address - Phone:214-468-8732
Practice Address - Fax:214-468-8834
Is Sole Proprietor?:No
Enumeration Date:2020-11-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49109183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist