Provider Demographics
NPI:1255924908
Name:MOGAKA, NAOMI KEMUNTO (PHARM D)
Entity type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:KEMUNTO
Last Name:MOGAKA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21650 FM 1093 RD APT 3312
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3145
Mailing Address - Country:US
Mailing Address - Phone:832-276-6462
Mailing Address - Fax:
Practice Address - Street 1:11540 WESTHEIMER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6708
Practice Address - Country:US
Practice Address - Phone:281-679-8031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-13
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty