Provider Demographics
NPI:1881921278
Name:EKWEGBARA, PETER OJUKWU (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:OJUKWU
Last Name:EKWEGBARA
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 S CARRIER PKWY
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-1511
Mailing Address - Country:US
Mailing Address - Phone:972-237-2121
Mailing Address - Fax:972-237-2112
Practice Address - Street 1:507 S CARRIER PKWY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-1511
Practice Address - Country:US
Practice Address - Phone:972-237-2121
Practice Address - Fax:972-237-2112
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40681183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist