MEDICARE: UCHENNA OGUGUA

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	3336C0003X	Community/Retail Pharmacy	29810	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2151448	OTHER		PK

General Provider Information

NPI Number	:	1558754218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UCHENNA OGUGUA

Provider Business Mailing Address
First Line	:	5019 RIVER KENTON
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-5418
Country	:	US
Telephone Number	:	210-371-4825
Fax Number	:

Provider Business Practice Location Address
First Line	:	2004 E HOUSTON ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78202-2934
Country	:	US
Telephone Number	:	210-224-7676
Fax Number	:	210-224-6131

Authorized Official
Title or Position	:	PHARMACIST
Name	:	UCHENNA OGUGUA
Credential	:
Telephone Number	:	210-371-4825

Provider Enumeration Date	:	03/05/2015
Last Update Date	:	04/17/2015

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Directions to “UCHENNA OGUGUA ” Practice Location

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