Provider Demographics
NPI:1598365272
Name:OBIKA, UGOCHUKWU OLISA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:UGOCHUKWU
Middle Name:OLISA
Last Name:OBIKA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4940 CATTLE LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79934-2835
Mailing Address - Country:US
Mailing Address - Phone:832-359-5308
Mailing Address - Fax:
Practice Address - Street 1:1850 N ZARAGOZA RD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7911
Practice Address - Country:US
Practice Address - Phone:915-855-6597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55991183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist