MEDICARE: DR. GEOFFREY OGBOGU II PHARM.D., CDM.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	42374	TX
2	1835P1200X	Pharmacotherapy Pharmacist	42374	TX

General Provider Information

NPI Number	:	1346241684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEOFFREY OGBOGU II PHARM.D., CDM.

Provider Business Mailing Address
First Line	:	6404 WILDWOOD CIR S
Second Line	:	715
City	:	FORT WORTH
State	:	TX
Zip	:	76132-5127
Country	:	US
Telephone Number	:	817-370-1624
Fax Number	:

Provider Business Practice Location Address
First Line	:	6404 WILDWOOD CIR S
Second Line	:	715
City	:	FORT WORTH
State	:	TX
Zip	:	76132-5127
Country	:	US
Telephone Number	:	817-370-1624
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	09/11/2025

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