Provider Demographics
NPI:1447467477
Name:NDUKWE, EDWIN AMOBI (PHARM D)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:AMOBI
Last Name:NDUKWE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13203 DUSTY GROVE LANE
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498
Mailing Address - Country:US
Mailing Address - Phone:281-277-7890
Mailing Address - Fax:
Practice Address - Street 1:1000 WILSON STREET
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471
Practice Address - Country:US
Practice Address - Phone:281-239-8484
Practice Address - Fax:281-239-8440
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42697183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist