Provider Demographics
NPI:1386239838
Name:NWOKE, CHIMEZIE (RPH)
Entity type:Individual
Prefix:
First Name:CHIMEZIE
Middle Name:
Last Name:NWOKE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 WASSON RD APT 55
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-6421
Mailing Address - Country:US
Mailing Address - Phone:214-650-7603
Mailing Address - Fax:
Practice Address - Street 1:201 W MARCY DR
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-6557
Practice Address - Country:US
Practice Address - Phone:432-267-1585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-06
Last Update Date:2021-08-03
Deactivation Date:2021-06-01
Deactivation Code:
Reactivation Date:2021-08-03
Provider Licenses
StateLicense IDTaxonomies
TX681381835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy