Provider Demographics
NPI:1811392822
Name:OTEGBULU, ADAORA SYLVIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ADAORA
Middle Name:SYLVIA
Last Name:OTEGBULU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3029 SUNRISE RUN LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1897
Mailing Address - Country:US
Mailing Address - Phone:832-287-0587
Mailing Address - Fax:
Practice Address - Street 1:3927 SPENCER HWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1200
Practice Address - Country:US
Practice Address - Phone:832-287-0587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-03
Last Update Date:2020-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist