Provider Demographics
NPI:1861552861
Name:ODITA, OGECHI (DC)
Entity type:Individual
Prefix:DR
First Name:OGECHI
Middle Name:
Last Name:ODITA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:OGECHI
Other - Middle Name:
Other - Last Name:GUINNESS-OHAZURUIKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:9304 FOREST LN STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6262
Mailing Address - Country:US
Mailing Address - Phone:214-802-2458
Mailing Address - Fax:972-279-0655
Practice Address - Street 1:9304 FOREST LN STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6262
Practice Address - Country:US
Practice Address - Phone:972-279-0644
Practice Address - Fax:972-279-0655
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor