Provider Demographics
NPI:1457060980
Name:EZEJI, OGECHI KRISTINE (PA)
Entity type:Individual
Prefix:
First Name:OGECHI
Middle Name:KRISTINE
Last Name:EZEJI
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Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:17300 DASHWOOD CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-5712
Mailing Address - Country:US
Mailing Address - Phone:512-484-6438
Mailing Address - Fax:
Practice Address - Street 1:4910 MUELLER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3079
Practice Address - Country:US
Practice Address - Phone:512-628-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2024-09-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant