Healthcare Provider Details

I. General information

NPI: 1184252371
Provider Name (Legal Business Name): NINA NNEKA OGUAMANAM M.D., MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NINA NNEKA OGUAMANAM

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 12/04/2023
Certification Date: 12/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 GARTH RD
BAYTOWN TX
77521-2122
US

IV. Provider business mailing address

2900 N LAKE SHORE DR
CHICAGO IL
60657-5640
US

V. Phone/Fax

Practice location:
  • Phone: 832-556-6351
  • Fax: 713-799-9598
Mailing address:
  • Phone: 773-665-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberU7486
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: