Provider Demographics
NPI:1366059263
Name:OKWARA, JOAN IJEOMA (PHARMD)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:IJEOMA
Last Name:OKWARA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 DOWLEN RD APT 85
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-6034
Mailing Address - Country:US
Mailing Address - Phone:978-996-7427
Mailing Address - Fax:
Practice Address - Street 1:496 HIGHWAY 96 S
Practice Address - Street 2:
Practice Address - City:SILSBEE
Practice Address - State:TX
Practice Address - Zip Code:77656-4810
Practice Address - Country:US
Practice Address - Phone:409-386-6959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57863183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist