Basic Information
| Provider Information | |||||||||
| NPI: | 1457952053 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OSAJI | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | OKONKWOR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | OSAJI | ||||||||
| OtherFirstName: | CHRISTOPHER | ||||||||
| OtherMiddleName: | OKONKWOR | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CHRISTOPHER OSAJI | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | WALMART PHARMACY | ||||||||
| Address2: | 510 KITTY HAWK RD | ||||||||
| City: | UNIVERSAL CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105368546 | ||||||||
| FaxNumber: | 2105368545 | ||||||||
| Practice Location | |||||||||
| Address1: | WALMART PHARMACY | ||||||||
| Address2: | 510 KITTY HAWK RD | ||||||||
| City: | UNIVERSAL CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105368546 | ||||||||
| FaxNumber: | 2105368545 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2020 | ||||||||
| LastUpdateDate: | 11/02/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 10/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 36314 | TX | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.