Active NPI
Theodora Iwudibia
- Pharmacist
- Fort Worth, TX
National Provider Identifier
1821905514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 76910
- Practice address
- 4200 E Lancaster Ave
Fort Worth, TX 76103-3223 - Phone
- (817) 413-7442
- NPI assigned
- Aug 26, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 76910 | TX | Primary |
Addresses
Primary practice location
4200 E Lancaster Ave
Fort Worth, TX 76103-3223
Mailing address
4200 E Lancaster Ave
Fort Worth, TX 76103-3223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787702400000",
"number": "1821905514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4200 E LANCASTER AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761033223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 E LANCASTER AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761033223",
"telephone_number": "817-413-7442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IWUDIBIA",
"first_name": "THEODORA",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-08-26",
"last_updated": "2026-08-26",
"certification_date": "2026-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "76910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.