Provider Demographics
NPI:1518295930
Name:EFFIONG, BASSEY OKON (RPH)
Entity Type:Individual
Prefix:MISS
First Name:BASSEY
Middle Name:OKON
Last Name:EFFIONG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8207 BARKER CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-1212
Mailing Address - Country:US
Mailing Address - Phone:281-858-0573
Mailing Address - Fax:281-861-6965
Practice Address - Street 1:8207 BARKER CYPRESS RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-1212
Practice Address - Country:US
Practice Address - Phone:281-858-0573
Practice Address - Fax:281-861-6965
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37171183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist