Provider Demographics
NPI:1114703402
Name:EKWUEME, AWUSAKU CHIDI (PHARMD)
Entity Type:Individual
Prefix:
First Name:AWUSAKU
Middle Name:CHIDI
Last Name:EKWUEME
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHIDI
Other - Middle Name:
Other - Last Name:EKWUEME
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5040 S COULTER ST APT 610
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-5423
Mailing Address - Country:US
Mailing Address - Phone:832-620-1875
Mailing Address - Fax:
Practice Address - Street 1:1300 S COULTER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1712
Practice Address - Country:US
Practice Address - Phone:832-620-1875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73056183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist