Provider Demographics
NPI:1770184236
Name:EMELOGU, CHUKWUEMEZIE FRANCIS (RPH)
Entity Type:Individual
Prefix:DR
First Name:CHUKWUEMEZIE
Middle Name:FRANCIS
Last Name:EMELOGU
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 1:1836 W DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-5411
Mailing Address - Country:US
Mailing Address - Phone:281-658-9988
Mailing Address - Fax:
Practice Address - Street 1:302 S PARK BLVD
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7835
Practice Address - Country:US
Practice Address - Phone:817-481-2598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65537183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist