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General NPI Number Information
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NPI Number | 1477211647
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Entity Type | Individual
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Provider Name | COLLINS ODUOGU PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 12/03/2021
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 5003 ANTOINE DR STE A
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City | HOUSTON
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State | TX
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Zip | 77092-3348
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Country | US
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Telephone | 713-290-8800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 925903
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City | HOUSTON
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State | TX
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Zip | 77292-5903
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Country | US
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Telephone | 713-884-9259
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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 | 45934
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License Number State | TX
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