Provider Demographics
NPI:1073840682
Name:OGUANOBI, CHIKE (RPH)
Entity Type:Individual
Prefix:
First Name:CHIKE
Middle Name:
Last Name:OGUANOBI
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 1:2614 LAVON DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-8762
Mailing Address - Country:US
Mailing Address - Phone:972-530-1438
Mailing Address - Fax:
Practice Address - Street 1:2614 LAVON DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-8762
Practice Address - Country:US
Practice Address - Phone:972-530-1438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40468183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist