Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | P0920 | TX |
NPI | 1053521583 |
---|---|
Provider Name | Dr. Okechukwu Ernest Obua |
First Address | Houston, TX 77077-1958 |
Second Address | Coatesville, PA 19320-2407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 18/12/2013 |