Provider Demographics
NPI:1811260904
Name:AMOS-NWANKWO, AUSTIN O (PHARM D)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:O
Last Name:AMOS-NWANKWO
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 N I ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-5607
Mailing Address - Country:US
Mailing Address - Phone:713-261-2031
Mailing Address - Fax:
Practice Address - Street 1:2212 N I ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5607
Practice Address - Country:US
Practice Address - Phone:713-261-2031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45127183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist