Individual
FATOUMATA KEITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 S LOOP 288, DENTON, TX 76205-4834
(940) 220-0574
Mailing address
1700 S LOOP 288, DENTON, TX 76205-4834
(940) 220-0574
(940) 220-0577
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
65510
TX
183700000X
Pharmacy Technician
—
—
Other
Enumeration date
05/12/2017
Last updated
12/24/2022
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