Provider Demographics
NPI:1336625219
Name:MEREMIKWU, ADAEZE
Entity type:Individual
Prefix:
First Name:ADAEZE
Middle Name:
Last Name:MEREMIKWU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EBONY
Other - Middle Name:
Other - Last Name:MEREMIKWU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5910 FAIRDALE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-5664
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8703 MEADOWCROFT DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5006
Practice Address - Country:US
Practice Address - Phone:713-840-7956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137699363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner