MEDICARE: MRS. NGOZI R IBE MA LBSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator	40006	TX

General Provider Information

NPI Number	:	1003962374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NGOZI R IBE MA LBSW

Provider Business Mailing Address
First Line	:	16138 NEW FIELD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-2823
Country	:	US
Telephone Number	:	832-882-9495
Fax Number	:	281-589-1390

Provider Business Practice Location Address
First Line	:	16138 NEW FIELD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-2823
Country	:	US
Telephone Number	:	832-882-9495
Fax Number	:	281-589-1390

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	07/09/2007

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