Healthcare Provider Details

I. General information

NPI: 1891395315
Provider Name (Legal Business Name): DAVID UWAKWE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2020
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 BEDFORD RD
BEDFORD TX
76021-5711
US

IV. Provider business mailing address

713 WARWICK BLVD
LEWISVILLE TX
75056-6280
US

V. Phone/Fax

Practice location:
  • Phone: 817-283-7529
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number52888
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: