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General NPI Number Information
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NPI Number | 1154743375
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Entity Type | Individual
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Provider Name | OGONNA ANNE OPURUM PHARM. D.
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Gender | Female
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Dates
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Enumeration Date | 01/07/2014
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Last Update Date | 01/07/2014
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Provider Practice Location Address
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Address Line | 11330 MONTWOOD DR
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City | EL PASO
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State | TX
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Zip | 79936
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Country | US
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Telephone | 915-855-4967
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 HUECO VALLEY DR APT 4601
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City | EL PASO
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State | TX
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Zip | 79938-5408
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Country | US
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Telephone | 202-468-1558
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 51928
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License Number State | TX
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