Healthcare Provider Details

I. General information

NPI: 1659957124
Provider Name (Legal Business Name): CHINEDU OKOCHA PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5080 VIRGINIA PKWY STE 550
MCKINNEY TX
75071-5633
US

IV. Provider business mailing address

5080 VIRGINIA PKWY STE 550
MCKINNEY TX
75071-5633
US

V. Phone/Fax

Practice location:
  • Phone: 972-540-9900
  • Fax: 972-540-9901
Mailing address:
  • Phone: 972-540-9900
  • Fax: 972-540-9901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number48186
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: