Healthcare Provider Details

I. General information

NPI: 1760047336
Provider Name (Legal Business Name): THERESA UWADIA OFILI RN, BS, PHARMD, MPH,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 05/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TEXAS A&M UNIVERSITY COLLEGE OF PHARMACY 206 OLSEN BLVD., REYNOLDS MEDICAL BLDG., SUITE 159
COLLEGE STATION TX
77843-1114
US

IV. Provider business mailing address

TEXAS A&M UNIVERSITY COLLEGE OF PHARMACY 206 OLSEN BLVD., REYNOLDS MEDICAL BLDG., SUITE 159
COLLEGE STATION TX
77843-1114
US

V. Phone/Fax

Practice location:
  • Phone: 979-436-0717
  • Fax:
Mailing address:
  • Phone: 979-436-0717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number502492
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number502492
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number502492
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number32875
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: