Healthcare Provider Details

I. General information

NPI: 1225631997
Provider Name (Legal Business Name): UGOCHINYERE A OKOLI PHARM D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: UGO A OKOLI PHARM D.

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 11/17/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1406 E MILAM ST
MEXIA TX
76667-2500
US

IV. Provider business mailing address

1406 E MILAM ST
MEXIA TX
76667-2500
US

V. Phone/Fax

Practice location:
  • Phone: 254-562-5551
  • Fax:
Mailing address:
  • Phone: 254-562-5551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number55468
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: