Obialo, Theodore C

Obialo, Theodore C is an individual health care provider with primary practice located at 3820 State Highway 64 W , Tyler TX 75704-6924. He recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist. Pharmacy Service Providers / Pharmacist is his primary health care specialty. Obialo, Theodore C can be contacted via phone (903) 597-3888.

Contact Information

Primary practice address
3820 State Highway 64 W Tyler TX 75704-6924
Phone: (903) 597-3888
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 33412 Texas
Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 33412 Texas

Profile Details

NPI number 1053630012
LBN Legal business name Obialo, Theodore C
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2010
Last updated Oct 8th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1053630012 NPPES
Texas Other 33412 PHARMACIST LICENCE

Popular Providers