Provider Demographics
NPI:1285894840
Name:IDOKOGI, VIOLET I
Entity type:Individual
Prefix:
First Name:VIOLET
Middle Name:I
Last Name:IDOKOGI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1549
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-8549
Mailing Address - Country:US
Mailing Address - Phone:281-635-1484
Mailing Address - Fax:
Practice Address - Street 1:2114 QUAIL VALLEY EAST DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3324
Practice Address - Country:US
Practice Address - Phone:281-635-1484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health