Provider Demographics
NPI:1073151916
Name:OFOEZE, NNAMDI (NP)
Entity type:Individual
Prefix:
First Name:NNAMDI
Middle Name:
Last Name:OFOEZE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23607 BATESVILLE CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-4176
Mailing Address - Country:US
Mailing Address - Phone:562-256-4810
Mailing Address - Fax:
Practice Address - Street 1:801 FM 1463 RD # 200-257
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7924
Practice Address - Country:US
Practice Address - Phone:281-562-9553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-11
Last Update Date:2024-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1072787363LP0808X
CA95013416363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health