Provider Demographics
NPI:1962062802
Name:OBI, ADAEZE PEACE
Entity type:Individual
Prefix:
First Name:ADAEZE
Middle Name:PEACE
Last Name:OBI
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 1:13100 W BELLFORT AVE APT 417
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-4833
Mailing Address - Country:US
Mailing Address - Phone:832-651-5843
Mailing Address - Fax:
Practice Address - Street 1:13100 W BELLFORT AVE APT 417
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-4833
Practice Address - Country:US
Practice Address - Phone:832-651-5843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX956698163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics