Provider Demographics
NPI:1407005747
Name:NWOKORIE, JUDITH C
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:C
Last Name:NWOKORIE
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 2236
Mailing Address - Street 2:
Mailing Address - City:ALIEF
Mailing Address - State:TX
Mailing Address - Zip Code:77411-2236
Mailing Address - Country:US
Mailing Address - Phone:713-988-2618
Mailing Address - Fax:713-988-2619
Practice Address - Street 1:9894 BISSONNET ST STE 290
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8285
Practice Address - Country:US
Practice Address - Phone:713-988-2618
Practice Address - Fax:713-988-2619
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-11
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX67-9518Medicare PIN