Provider Demographics
NPI:1942989819
Name:ACHIKEH, OBIAGELI CYNTHIA
Entity Type:Individual
Prefix:
First Name:OBIAGELI
Middle Name:CYNTHIA
Last Name:ACHIKEH
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 1:3301 N FM 1417 APT 723
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-3439
Mailing Address - Country:US
Mailing Address - Phone:903-294-9744
Mailing Address - Fax:
Practice Address - Street 1:3301 N FM 1417 APT 723
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-3439
Practice Address - Country:US
Practice Address - Phone:903-294-9744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72485183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist