Wali Abdul, PHARM. D.

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Dallas, TX

NPI 1962013300 · NPPES record last updated Aug 10, 2020

Key facts

NPI
1962013300
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
67062 (TX)
Practice address
9140 Forest LN
Dallas, TX 75243-4202
Phone
(214) 221-0978
NPI assigned
Aug 10, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
67062TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Texas L P Past
since Aug 16, 2020
Accepting new patients
Kroger Texas LP Past
since Aug 16, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 67062 TX Yes

Addresses

Primary practice location

9140 Forest LN
Dallas, TX 75243-4202

Mailing address

18116 Peppy PL
Dallas, TX 75252-2700
Phone (682) 888-7543

Other practice location 1

17194 Preston Rd
Dallas, TX 75248-1221
Phone (972) 931-9371

Other providers in Dallas, TX

All providers in Dallas, TX · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Texas

Sources for this page

Verify at the official NPI Registry.