Provider Demographics
NPI:1437932993
Name:EKABO, OPINYA (RPH)
Entity type:Individual
Prefix:DR
First Name:OPINYA
Middle Name:
Last Name:EKABO
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 1:3440 HERITAGE CIR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-3963
Mailing Address - Country:US
Mailing Address - Phone:956-466-1040
Mailing Address - Fax:
Practice Address - Street 1:1002 DIXIELAND RD
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-5913
Practice Address - Country:US
Practice Address - Phone:956-440-8329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42310183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty