Individual
CHARLES EBILIEKWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
100 E FM 495, SAN JUAN, TX 78589-3710
(956) 283-7880
Mailing address
810 S TAYLOR RD APT 927, MISSION, TX 78572-0227
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
53910
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53910
TEXAS STATE BOARD OF PHARMACY
TX
Enumeration date
11/19/2020
Last updated
11/19/2020
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