Provider Demographics
NPI:1659608529
Name:AZUIKE, MARY EBEHIREME (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:EBEHIREME
Last Name:AZUIKE
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 1:11675 W AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:MEADOWS PLACE
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3041
Mailing Address - Country:US
Mailing Address - Phone:281-313-6403
Mailing Address - Fax:281-313-6407
Practice Address - Street 1:11675 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:MEADOWS PLACE
Practice Address - State:TX
Practice Address - Zip Code:77477-3041
Practice Address - Country:US
Practice Address - Phone:281-313-6403
Practice Address - Fax:281-313-6407
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist