Provider Demographics
NPI:1225876311
Name:NNAMDI, OGBONNA PRINCE
Entity type:Individual
Prefix:
First Name:OGBONNA
Middle Name:PRINCE
Last Name:NNAMDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 FOUNTAIN VIEW DR STE 464
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4819
Mailing Address - Country:US
Mailing Address - Phone:832-736-8357
Mailing Address - Fax:832-234-7594
Practice Address - Street 1:2401 FOUNTAIN VIEW DR STE 464
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-4819
Practice Address - Country:US
Practice Address - Phone:832-736-8357
Practice Address - Fax:832-234-7594
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1173674363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health