Provider Demographics
NPI:1639553431
Name:AKUBUKWE, BARTHOLOMEW A (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BARTHOLOMEW
Middle Name:A
Last Name:AKUBUKWE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 LENNOX WAY
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8628
Mailing Address - Country:US
Mailing Address - Phone:832-298-1971
Mailing Address - Fax:817-377-8452
Practice Address - Street 1:6700 WESTFREE WAY
Practice Address - Street 2:
Practice Address - City:FORTWORTH
Practice Address - State:TX
Practice Address - Zip Code:76116
Practice Address - Country:US
Practice Address - Phone:817-377-8078
Practice Address - Fax:817-377-8452
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX44103183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist