1528276920 NPI number — DR. OKEZIE ONYEBUENYI UKEGBU PA; DC

Table of content: DR. OKEZIE ONYEBUENYI UKEGBU PA; DC (NPI 1528276920)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528276920 NPI number — DR. OKEZIE ONYEBUENYI UKEGBU PA; DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
UKEGBU
Provider First Name:
OKEZIE
Provider Middle Name:
ONYEBUENYI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PA; DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528276920
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10906 SAGECREST LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77089-3902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-891-5868
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
630 MURPHY RD STE 112
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STAFFORD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77477-5928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-552-8898
Provider Business Practice Location Address Fax Number:
281-978-2690
Provider Enumeration Date:
05/18/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AS0400X , with the licence number:  PA02248 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: 9911 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)