Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | 35.086016 | OH |
N | 207RN0300X | Nephrologist | 7363 | SD |
Y | 207RN0300X | Nephrologist | N5305 | TX |
NPI | 1003087388 |
---|---|
Provider Name | Ifeatu Uchenna Oti |
First Address | Tyler, TX 75701-2130 |
Second Address | Tyler, TX 75701-2130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2008 |
Last Update Date | 08/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200280780 A | (05) | OK |
2108011-01 | (05) | TX |