Provider Demographics
NPI:1811992191
Name:NNABUIFE, CALISTA UCHE (RPH)
Entity type:Individual
Prefix:MRS
First Name:CALISTA
Middle Name:UCHE
Last Name:NNABUIFE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4338 BOBOLINK CIR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2980
Mailing Address - Country:US
Mailing Address - Phone:281-536-4071
Mailing Address - Fax:
Practice Address - Street 1:4338 BOBOLINK CIR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2980
Practice Address - Country:US
Practice Address - Phone:281-536-4071
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX31472OtherPHARMACIST LICENSE NUMBER