Provider Demographics
NPI:1306174578
Name:IJIE, KENNEDY EHIMARE SR (RPH)
Entity type:Individual
Prefix:MR
First Name:KENNEDY
Middle Name:EHIMARE
Last Name:IJIE
Suffix:SR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16506 FM 529 RD STE 108
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1462
Mailing Address - Country:US
Mailing Address - Phone:281-815-7366
Mailing Address - Fax:281-815-7258
Practice Address - Street 1:16506 FM 529 RD STE 108
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-1462
Practice Address - Country:US
Practice Address - Phone:281-498-3734
Practice Address - Fax:281-498-4144
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-30
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44647183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist