Provider Demographics
NPI:1336737782
Name:AKUCHIE, QUEEN OPARA
Entity Type:Individual
Prefix:
First Name:QUEEN
Middle Name:OPARA
Last Name:AKUCHIE
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 1:11112 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-4790
Mailing Address - Country:US
Mailing Address - Phone:713-458-2871
Mailing Address - Fax:
Practice Address - Street 1:11112 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-4790
Practice Address - Country:US
Practice Address - Phone:713-458-2871
Practice Address - Fax:713-458-2876
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46482183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty