Provider Demographics
NPI:1174240865
Name:AKUNNA, CHUKWUDI (RPH)
Entity type:Individual
Prefix:
First Name:CHUKWUDI
Middle Name:
Last Name:AKUNNA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 WASHINGTON DR APT 8214
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-3621
Mailing Address - Country:US
Mailing Address - Phone:469-316-1031
Mailing Address - Fax:
Practice Address - Street 1:3012 MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-2323
Practice Address - Country:US
Practice Address - Phone:214-363-5525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist