Provider Demographics
NPI:1740907708
Name:OMUERO, OGHENETEGA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:OGHENETEGA
Middle Name:
Last Name:OMUERO
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 1:8789 FM 1960 BYPASS RD W
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4021
Mailing Address - Country:US
Mailing Address - Phone:281-548-1020
Mailing Address - Fax:
Practice Address - Street 1:8789 FM 1960 BYPASS RD W
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4021
Practice Address - Country:US
Practice Address - Phone:281-548-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69490183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist