MEDICARE: KELECHI UGWUADU

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	55136	TX

General Provider Information

NPI Number	:	1295334886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELECHI UGWUADU

Provider Business Mailing Address
First Line	:	6425 FM 1464 RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-8287
Country	:	US
Telephone Number	:	832-746-7371
Fax Number	:

Provider Business Practice Location Address
First Line	:	6425 FM 1464 RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-8287
Country	:	US
Telephone Number	:	281-277-2242
Fax Number	:

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

Provider Enumeration Date	:	10/23/2020
Last Update Date	:	10/23/2020

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Directions to “ KELECHI UGWUADU ” Practice Location

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