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NPI Code Detail

MEDICARE: MR. OFONIME NTIA NP

MEDICARE: MR. OFONIME NTIA NP
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
1163W00000XRegistered Nurse101563OK
2363LF0000XFamily Nurse PractitionerF09170912OK
3363L00000XNurse PractitionerAP136791TX

General Provider Information

NPI Number : 1720529910
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. OFONIME NTIA NP
Provider Business Mailing Address
First Line : 16107 KENSINGTON DR STE 126
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-4224
Country : US
Telephone Number : 281-783-8162
Fax Number : 281-895-3083
Provider Business Practice Location Address
First Line : 8720 HIGHWAY 6 STE 400
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-7108
Country : US
Telephone Number : 281-783-8162
Fax Number : 281-895-3083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2017
Last Update Date : 01/16/2024

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