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General NPI Number Information
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NPI Number | 1649931890
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Entity Type | Individual
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Provider Name | PRINCE IKENNA IBE
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Gender | Male
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Dates
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Enumeration Date | 01/09/2022
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Last Update Date | 01/09/2022
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Provider Practice Location Address
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Address Line | 2710 PEARLAND PARKWAY
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City | PEARLAND
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State | TX
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Zip | 77581
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Country | US
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Telephone | 281-485-5047
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Fax |
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Provider Business Mailing Address
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Address Line | 10811 SHANNON MILLS LN
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City | HOUSTON
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State | TX
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Zip | 77075
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Country | US
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Telephone | 832-891-5321
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 254081
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License Number State | TX
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