Provider Demographics
NPI:1962616391
Name:ADIUKU, VICTOR OKEY (ADMINISTRATOR)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:OKEY
Last Name:ADIUKU
Suffix:
Gender:M
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 FONDREN RD
Mailing Address - Street 2:SUITE 250C
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-4564
Mailing Address - Country:US
Mailing Address - Phone:713-777-3434
Mailing Address - Fax:713-777-3593
Practice Address - Street 1:10101 FONDREN RD
Practice Address - Street 2:SUITE 250C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4564
Practice Address - Country:US
Practice Address - Phone:713-777-3434
Practice Address - Fax:713-777-3593
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0103353747P1801X, 376J00000X, 372500000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXVICTOR20000Medicaid