Individual
MR. BAMIDELE OTUNUGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
5270 S STATE HIGHWAY 360, TARGET PHARMACY (T-2243), GRAND PRAIRIE, TX 75052-8307
(469) 348-2101
Mailing address
5270 S STATE HIGHWAY 360, TARGET PHARMACY (T-2243), GRAND PRAIRIE, TX 75052-8307
(469) 348-2101
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
39744
TX
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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