Provider Demographics
NPI:1386247500
Name:ONWUKA, BENSON U (BS PHARMACY)
Entity type:Individual
Prefix:MR
First Name:BENSON
Middle Name:U
Last Name:ONWUKA
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 BOLIVAR DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3893
Mailing Address - Country:US
Mailing Address - Phone:817-800-2802
Mailing Address - Fax:
Practice Address - Street 1:8560 S HULEN ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-2741
Practice Address - Country:US
Practice Address - Phone:817-292-0048
Practice Address - Fax:817-292-7593
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist