Provider Demographics
NPI:1346733482
Name:AGBAZUE, LINDA NWANNEKA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:NWANNEKA
Last Name:AGBAZUE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:NWANNEKA
Other - Last Name:MBAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6282
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77491-6282
Mailing Address - Country:US
Mailing Address - Phone:832-273-0079
Mailing Address - Fax:
Practice Address - Street 1:14021 STUEBNER AIRLINE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4609
Practice Address - Country:US
Practice Address - Phone:281-440-1604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2020-09-01
Deactivation Date:2019-04-26
Deactivation Code:
Reactivation Date:2020-09-01
Provider Licenses
StateLicense IDTaxonomies
TX53825183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist