Healthcare Provider Details

I. General information

NPI: 1952029431
Provider Name (Legal Business Name): VICTORIA C. OGBONNA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 08/19/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 ADMINISTRATION DRIVE
DENTON TX
76204
US

IV. Provider business mailing address

304 ADMINISTRATION DR.
DENTON TX
76204
US

V. Phone/Fax

Practice location:
  • Phone: 940-898-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1071894
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: