Healthcare Provider Details
I. General information
NPI: 1114255098
Provider Name (Legal Business Name): OLUCHI ANNETTE OGU PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/03/2009
Last Update Date: 12/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3801 FM 3009
SCHERTZ TX
78154-1132
US
IV. Provider business mailing address
3801 FM 3009
SCHERTZ TX
78154-1132
US
V. Phone/Fax
- Phone: 210-566-3245
- Fax:
- Phone: 210-566-3245
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 47648 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: