Provider Demographics
NPI:1053649962
Name:AWARAKA, CAROLYN NGOZI (RPH)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:NGOZI
Last Name:AWARAKA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 MASONGLEN CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-8817
Mailing Address - Country:US
Mailing Address - Phone:832-654-0557
Mailing Address - Fax:281-342-3004
Practice Address - Street 1:7102 FM 1464 RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-6429
Practice Address - Country:US
Practice Address - Phone:281-494-1984
Practice Address - Fax:281-494-2492
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40729183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist