Provider Demographics
NPI:1821693458
Name:MWAKA, VERA AWAH (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:VERA
Middle Name:AWAH
Last Name:MWAKA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:VERA
Other - Middle Name:NCHANGNWI
Other - Last Name:AWAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1500 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-3004
Mailing Address - Country:US
Mailing Address - Phone:936-327-2561
Mailing Address - Fax:936-327-0092
Practice Address - Street 1:1500 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-3004
Practice Address - Country:US
Practice Address - Phone:936-327-2561
Practice Address - Fax:936-327-0092
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist