Provider Demographics
NPI:1235947433
Name:NWANKPA, STEPHEN U (DR)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:U
Last Name:NWANKPA
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7510 SWEETWATER LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4808
Mailing Address - Country:US
Mailing Address - Phone:310-634-3515
Mailing Address - Fax:
Practice Address - Street 1:6151 MATLOCK RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-2206
Practice Address - Country:US
Practice Address - Phone:817-465-6537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68192183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist