Provider Demographics
NPI:1992337257
Name:ANYAKUDO, OZIOMA G
Entity type:Individual
Prefix:
First Name:OZIOMA
Middle Name:G
Last Name:ANYAKUDO
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 1:16646 BROADOAK GROVE LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7170
Mailing Address - Country:US
Mailing Address - Phone:832-566-8026
Mailing Address - Fax:
Practice Address - Street 1:2815 W TC JESTER BLVD, HOUSTON, TEXAS 77018
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018
Practice Address - Country:US
Practice Address - Phone:713-885-7507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251545363LP0808X
WAAP61490377363LP0808X
TXAP144222363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health