Individual
DR. IMINABO SAMSON BEREPELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3812 GILMER RD, LONGVIEW, TX 75604-1173
(903) 475-0477
(903) 475-0478
Mailing address
3812 GILMER RD, LONGVIEW, TX 75604-1173
(903) 475-0477
(903) 475-0478
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
54617
TX
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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