Individual
EKENEDIRICHUKWU AGBASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3802 E BROAD ST, MANSFIELD, TX 76063-5617
(817) 473-1373
Mailing address
2924 LUCAS DR APT 3090, DALLAS, TX 75219-5656
(302) 388-7397
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
59546
TX
Other
Enumeration date
12/07/2020
Last updated
12/07/2020
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