Healthcare Provider Details

I. General information

NPI: 1902406754
Provider Name (Legal Business Name): AHUNNA NNEKA UKEGBU PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2020
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4746 TWIN CITY HWY
GROVES TX
77619-3038
US

IV. Provider business mailing address

2600 WESTHOLLOW DR APT 1910
HOUSTON TX
77082-1937
US

V. Phone/Fax

Practice location:
  • Phone: 409-960-6394
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number64106
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: