Provider Demographics
NPI:1396336046
Name:OGU, CLEMENT ONYEMAECHI
Entity type:Individual
Prefix:
First Name:CLEMENT
Middle Name:ONYEMAECHI
Last Name:OGU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7403 LAVAERTON WOOD LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3185
Mailing Address - Country:US
Mailing Address - Phone:832-607-6012
Mailing Address - Fax:
Practice Address - Street 1:7505 FANNIN ST STE 140
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1975
Practice Address - Country:US
Practice Address - Phone:713-790-1228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41467183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist