MEDICARE: MRS. ANNASTECIA CHINASA OKIBE

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	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	AP144912	TX
2	163WP0807X	Child & Adolescent Psychiatric/Mental Health Registered Nurse	AP144912	TX

General Provider Information

NPI Number	:	1154956811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNASTECIA CHINASA OKIBE

Provider Business Mailing Address
First Line	:	4810 RIVERSTONE BLVD
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4092
Country	:	US
Telephone Number	:	832-916-2677
Fax Number	:	832-802-6163

Provider Business Practice Location Address
First Line	:	4810 RIVERSTONE BLVD STE 100
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4092
Country	:	US
Telephone Number	:	713-741-5050
Fax Number	:

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

Provider Enumeration Date	:	03/03/2020
Last Update Date	:	04/03/2025

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