Provider Demographics
NPI:1528492626
Name:NANYINGAH, DASIME ITOE (PHARMD)
Entity type:Individual
Prefix:
First Name:DASIME
Middle Name:ITOE
Last Name:NANYINGAH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1672 PATIO TER
Mailing Address - Street 2:# B
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-8441
Mailing Address - Country:US
Mailing Address - Phone:913-636-0508
Mailing Address - Fax:
Practice Address - Street 1:1672 PATIO TER
Practice Address - Street 2:# B
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-8441
Practice Address - Country:US
Practice Address - Phone:913-636-0508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist