MEDICARE: THERESA UWADIA OFILI RN, BS, PHARMD, MPH,

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	163W00000X	Registered Nurse	502492	TX
2	163WM0102X	Maternal Newborn Registered Nurse	502492	TX
3	163WN0002X	Neonatal Intensive Care Registered Nurse	502492	TX
4	183500000X	Pharmacist	32875	TX

General Provider Information

NPI Number	:	1760047336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA UWADIA OFILI RN, BS, PHARMD, MPH,

Provider Business Mailing Address
First Line	:	TEXAS A&M UNIVERSITY COLLEGE OF PHARMACY
Second Line	:	206 OLSEN BLVD., REYNOLDS MEDICAL BLDG., SUITE 159
City	:	COLLEGE STATION
State	:	TX
Zip	:	77843-1114
Country	:	US
Telephone Number	:	979-436-0717
Fax Number	:

Provider Business Practice Location Address
First Line	:	TEXAS A&M UNIVERSITY COLLEGE OF PHARMACY
Second Line	:	206 OLSEN BLVD., REYNOLDS MEDICAL BLDG., SUITE 159
City	:	COLLEGE STATION
State	:	TX
Zip	:	77843-1114
Country	:	US
Telephone Number	:	979-436-0717
Fax Number	:

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

Provider Enumeration Date	:	05/08/2019
Last Update Date	:	05/08/2019

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