Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | E-12253 | AR |
N | 207P00000X | Emergency Physician | K1890 | TX |
Y | 207Q00000X | Family Doctor | K1890 | TX |
NPI | 1003871658 |
---|---|
Provider Name | Dr. Catherine Eno Okpon Onabajo |
First Address | Coppell, TX 75019-2574 |
Second Address | Lewisville, TX 75067-3426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 07/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
137971121 | (05) | TX |
176341902 | (05) | TX |
8U0990 | BLUE SHIELD (01) | TX |
G39419 | (02) | TX |