Provider Demographics
NPI:1144934951
Name:UGBAJA, CHIDERAH PEACE
Entity type:Individual
Prefix:DR
First Name:CHIDERAH
Middle Name:PEACE
Last Name:UGBAJA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 S 77 SUNSHINESTRIP
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8355
Mailing Address - Country:US
Mailing Address - Phone:956-423-2986
Mailing Address - Fax:
Practice Address - Street 1:2325 S 77 SUNSHINESTRIP
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8355
Practice Address - Country:US
Practice Address - Phone:956-423-2986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71565183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist