=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851696504
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOZIE'S PHARMACY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/11/2011
-----------------------------------------------------
Last Update Date | 01/11/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12660 BEECHNUT ST SUITE 130
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77072-3981
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-933-6600
-----------------------------------------------------
Fax | 281-933-6601
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12660 BEECHNUT ST SUITE 130
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77072-3981
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-933-6600
-----------------------------------------------------
Fax | 281-933-6601
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST IN CHARGE
-----------------------------------------------------
Name | DR. MARYQUEEN ONUAWUCHI CHILAKA
-----------------------------------------------------
Credential | DOCTOR OF PHARMACY
-----------------------------------------------------
Telephone | 281-933-6600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 27283
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------