Provider Demographics
NPI:1508467275
Name:OBUEKWE, VICTOR CHIKE
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:CHIKE
Last Name:OBUEKWE
Suffix:
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 1:5504 MARIGOLD CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-4983
Mailing Address - Country:US
Mailing Address - Phone:817-478-7722
Mailing Address - Fax:817-478-7722
Practice Address - Street 1:1221 FM 1187 E
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-4370
Practice Address - Country:US
Practice Address - Phone:682-233-7841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-07
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist