MEDICARE: JOVIANE OGU

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	183500000X	Pharmacist	59850	TX
2	183500000X	Pharmacist	PH235999	MA

General Provider Information

NPI Number	:	1942907886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOVIANE OGU

Provider Business Mailing Address
First Line	:	8529 MONTRIDGE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-1438
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8529 MONTRIDGE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-1438
Country	:	US
Telephone Number	:	617-894-7870
Fax Number	:

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

Provider Enumeration Date	:	02/10/2023
Last Update Date	:	02/10/2023

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Directions to “ JOVIANE OGU ” Practice Location

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