MEDICARE: DR. JOY E AGUWA PHARMD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133NN1002X	Nutrition Education Nutritionist
2	172V00000X	Community Health Worker
3	174H00000X	Health Educator
4	183500000X	Pharmacist	43664	TX

General Provider Information

NPI Number	:	1184600413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOY E AGUWA PHARMD.

Provider Business Mailing Address
First Line	:	13601 PRESTON RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-4911
Country	:	US
Telephone Number	:	214-613-2019
Fax Number	:

Provider Business Practice Location Address
First Line	:	13601 PRESTON RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-4911
Country	:	US
Telephone Number	:	214-613-2019
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	03/28/2020

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