Provider Demographics
NPI:1912729435
Name:OBIORAH, ONYINYE MARYGRACE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ONYINYE
Middle Name:MARYGRACE
Last Name:OBIORAH
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9550 SKILLMAN ST # 330
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-8261
Mailing Address - Country:US
Mailing Address - Phone:469-588-1502
Mailing Address - Fax:
Practice Address - Street 1:9550 SKILLMAN ST # 330
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-8261
Practice Address - Country:US
Practice Address - Phone:469-588-1502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1041108363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health