Provider Demographics
NPI:1598368730
Name:CHIBUEZE, ONOCHIE STEPHEN (RPH)
Entity Type:Individual
Prefix:
First Name:ONOCHIE
Middle Name:STEPHEN
Last Name:CHIBUEZE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BALMORAL CIR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-2333
Mailing Address - Country:US
Mailing Address - Phone:682-701-1985
Mailing Address - Fax:
Practice Address - Street 1:4101 E 42ND ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-7239
Practice Address - Country:US
Practice Address - Phone:432-366-1160
Practice Address - Fax:432-366-8186
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist