Provider Demographics
NPI:1861816431
Name:ANOKWA, OBIAGERI
Entity Type:Individual
Prefix:
First Name:OBIAGERI
Middle Name:
Last Name:ANOKWA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 N MIDLAND DR APT 51
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-6437
Mailing Address - Country:US
Mailing Address - Phone:857-249-2787
Mailing Address - Fax:
Practice Address - Street 1:301 ANDREWS HWY
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6333
Practice Address - Country:US
Practice Address - Phone:432-685-3092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54282183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist