Provider Demographics
NPI:1245895242
Name:NWABUONA, CHINEDU (PHARMD)
Entity type:Individual
Prefix:
First Name:CHINEDU
Middle Name:
Last Name:NWABUONA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12627 CITY VILLAGE LANE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047
Mailing Address - Country:US
Mailing Address - Phone:832-889-4437
Mailing Address - Fax:
Practice Address - Street 1:2314 E INTERSTATE HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-8685
Practice Address - Country:US
Practice Address - Phone:956-585-3990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55993183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist