Provider Demographics
NPI:1306440581
Name:MOMOH, VIOLET UCHECHI (PHARMD)
Entity type:Individual
Prefix:
First Name:VIOLET
Middle Name:UCHECHI
Last Name:MOMOH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-5316
Mailing Address - Country:US
Mailing Address - Phone:347-668-2646
Mailing Address - Fax:
Practice Address - Street 1:775 E US HIGHWAY 80
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-8622
Practice Address - Country:US
Practice Address - Phone:972-552-1634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52787183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist