Provider Demographics
NPI:1023341419
Name:AGBEBAKU, JOSEPH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:AGBEBAKU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9603 NEW KENT DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-1039
Mailing Address - Country:US
Mailing Address - Phone:832-640-8979
Mailing Address - Fax:281-741-1936
Practice Address - Street 1:9603 NEW KENT DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498
Practice Address - Country:US
Practice Address - Phone:832-640-8979
Practice Address - Fax:832-640-8979
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2014-02-11
Deactivation Date:2009-11-04
Deactivation Code:
Reactivation Date:2009-12-22
Provider Licenses
StateLicense IDTaxonomies
TX42000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist