Provider Demographics
NPI:1285488916
Name:NWANNA, CHIDERA NICOLE ZELUNJOR
Entity type:Individual
Prefix:
First Name:CHIDERA NICOLE
Middle Name:ZELUNJOR
Last Name:NWANNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MAXEY RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77013-5036
Mailing Address - Country:US
Mailing Address - Phone:713-330-4552
Mailing Address - Fax:
Practice Address - Street 1:500 MAXEY RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77013-5036
Practice Address - Country:US
Practice Address - Phone:713-330-4552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72181183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist