Provider Demographics
NPI:1013513126
Name:KIHENGU, ELIAKUNDA MAGWE
Entity Type:Individual
Prefix:
First Name:ELIAKUNDA
Middle Name:MAGWE
Last Name:KIHENGU
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 1:6504 W LITTLE YORK RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-4802
Mailing Address - Country:US
Mailing Address - Phone:713-937-9600
Mailing Address - Fax:713-983-6221
Practice Address - Street 1:6504 W LITTLE YORK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-4802
Practice Address - Country:US
Practice Address - Phone:713-937-9600
Practice Address - Fax:713-983-6221
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist