Provider Demographics
NPI:1144818287
Name:ISOLA, ADETUNJI RAYMOND (RPH)
Entity type:Individual
Prefix:DR
First Name:ADETUNJI
Middle Name:RAYMOND
Last Name:ISOLA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2570 LAKE RIDGE ROAD
Mailing Address - Street 2:APT 9322
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056
Mailing Address - Country:US
Mailing Address - Phone:908-265-5854
Mailing Address - Fax:
Practice Address - Street 1:725 HEBRON PKWY
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057
Practice Address - Country:US
Practice Address - Phone:972-459-5906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX643603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy