Provider Demographics
NPI:1699660027
Name:IWUANYANWU, KELECHI
Entity type:Individual
Prefix:
First Name:KELECHI
Middle Name:
Last Name:IWUANYANWU
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 1:2602 GRANITE CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9155
Mailing Address - Country:US
Mailing Address - Phone:832-775-5637
Mailing Address - Fax:
Practice Address - Street 1:3232 MERIDIANA PKWY
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-3384
Practice Address - Country:US
Practice Address - Phone:832-775-5637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75566183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist