Provider Demographics
NPI:1194204479
Name:EKECHUKWU, CELESTINE I
Entity Type:Individual
Prefix:DR
First Name:CELESTINE
Middle Name:
Last Name:EKECHUKWU
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9888 BISSONNET ST STE 235
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8248
Mailing Address - Country:US
Mailing Address - Phone:281-396-3899
Mailing Address - Fax:
Practice Address - Street 1:9888 BISSONNET ST STE 235
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8248
Practice Address - Country:US
Practice Address - Phone:281-396-3899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47566183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXNAMedicaid