Provider Demographics
NPI:1821800137
Name:OBAROGIE, FAITH O
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:O
Last Name:OBAROGIE
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 1:1532 STEWART DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6599
Mailing Address - Country:US
Mailing Address - Phone:570-677-9792
Mailing Address - Fax:
Practice Address - Street 1:1532 STEWART DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6599
Practice Address - Country:US
Practice Address - Phone:570-677-9792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program