Provider Demographics
NPI:1942911243
Name:AWUKAM, BLESSING
Entity Type:Individual
Prefix:
First Name:BLESSING
Middle Name:
Last Name:AWUKAM
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 1:8811 SIENNA SPRINGS BLVD APT 2327
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-7337
Mailing Address - Country:US
Mailing Address - Phone:281-818-3237
Mailing Address - Fax:
Practice Address - Street 1:910 W DAVIS ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-2709
Practice Address - Country:US
Practice Address - Phone:936-539-1849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71397183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist