MEDICARE: EMMANUEL ODINIGWE

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	1835X0200X	Oncology Pharmacist	57572	TX

General Provider Information

NPI Number	:	1639998271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMANUEL ODINIGWE

Provider Business Mailing Address
First Line	:	1600 ELDRIDGE PKWY APT#3607
Second Line	:	3607
City	:	HOUSTON
State	:	TX
Zip	:	77077
Country	:	US
Telephone Number	:	832-630-1354
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 ELDRIDGE PKWY APT#3607
Second Line	:	3607
City	:	HOUSTON
State	:	TX
Zip	:	77077
Country	:	US
Telephone Number	:	832-630-1354
Fax Number	:

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

Provider Enumeration Date	:	10/09/2024
Last Update Date	:	10/09/2024

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