Provider Demographics
NPI:1487279691
Name:OGBU, CHUKWUEMEKA (RPH)
Entity type:Individual
Prefix:
First Name:CHUKWUEMEKA
Middle Name:
Last Name:OGBU
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 1:21803 W INTERSTATE 10 STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1815
Mailing Address - Country:US
Mailing Address - Phone:210-886-8013
Mailing Address - Fax:
Practice Address - Street 1:21920 BULVERDE RD # 102-103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-2181
Practice Address - Country:US
Practice Address - Phone:210-503-5063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61680183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist