Provider Demographics
NPI:1942211123
Name:ANUDOKEM, CHINWEKELE IHUOMA (RPH)
Entity type:Individual
Prefix:MRS
First Name:CHINWEKELE
Middle Name:IHUOMA
Last Name:ANUDOKEM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5023
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76505-5023
Mailing Address - Country:US
Mailing Address - Phone:254-770-5468
Mailing Address - Fax:254-770-5468
Practice Address - Street 1:1901 S 1ST ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-7451
Practice Address - Country:US
Practice Address - Phone:254-743-0766
Practice Address - Fax:254-743-0020
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35415183500000X
CA50795183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist