Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 31595 | TX |
NPI | 1235785205 |
---|---|
Provider Name | Ogechi Anthonia Obiakor |
First Address | San Antonio, TX 78229-2722 |
Second Address | Gonzales, TX 78629-3910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2019 |
Last Update Date | 14/08/2019 |