Provider Demographics
NPI:1659855260
Name:AKWUBA, VICTOR IFEANYI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:IFEANYI
Last Name:AKWUBA
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 1:1835 LEANN LN
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-8109
Mailing Address - Country:US
Mailing Address - Phone:651-303-3003
Mailing Address - Fax:
Practice Address - Street 1:1619 AMBLER AVE
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2235
Practice Address - Country:US
Practice Address - Phone:325-672-4100
Practice Address - Fax:325-670-9100
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62195183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist