Provider Demographics
NPI:1851997431
Name:ANOZIE, OGECHUKWU IFEANYI
Entity Type:Individual
Prefix:
First Name:OGECHUKWU
Middle Name:IFEANYI
Last Name:ANOZIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4114 RAYADO CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4084
Mailing Address - Country:US
Mailing Address - Phone:832-630-6749
Mailing Address - Fax:
Practice Address - Street 1:3205 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2507
Practice Address - Country:US
Practice Address - Phone:361-814-8305
Practice Address - Fax:361-814-8623
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48163183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist