Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 14558 | MD |
Y | 1223P0221X | Pediatric Dentist | 34492 | TX |
NPI | 1023319571 |
---|---|
Provider Name | Malije Onwueme |
First Address | Katy, TX 77491-6389 |
Second Address | Waco, TX 76710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2010 |
Last Update Date | 18/09/2018 |