Provider Demographics
NPI:1215669288
Name:OMALIKO, IFEOMA UKAMAKA (APRN, PMHNP-C)
Entity type:Individual
Prefix:
First Name:IFEOMA
Middle Name:UKAMAKA
Last Name:OMALIKO
Suffix:
Gender:F
Credentials:APRN, PMHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9711 S MASON RD STE 125
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-7169
Mailing Address - Country:US
Mailing Address - Phone:346-933-2463
Mailing Address - Fax:713-234-7382
Practice Address - Street 1:9711 S MASON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-7167
Practice Address - Country:US
Practice Address - Phone:346-933-2463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1073759363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health