Healthcare Provider Details

I. General information

NPI: 1205456456
Provider Name (Legal Business Name): CHIOMA JISREAL OGBEJESI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2020
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27700 NORTHWEST FWY STE 600
CYPRESS TX
77433-7218
US

IV. Provider business mailing address

909 FROSTWOOD DR STE 1.405
HOUSTON TX
77024-2301
US

V. Phone/Fax

Practice location:
  • Phone: 346-231-6750
  • Fax:
Mailing address:
  • Phone: 713-338-5519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberV2191
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: