Provider Demographics
NPI:1427637693
Name:DUKU, EMMANUEL (RPH)
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:DUKU
Suffix:
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 1:401 CREPE MYRTLE LN
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4350
Mailing Address - Country:US
Mailing Address - Phone:972-992-8789
Mailing Address - Fax:
Practice Address - Street 1:10455 N CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2213
Practice Address - Country:US
Practice Address - Phone:214-369-3872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42315183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX42315Medicaid