Healthcare Provider Details

I. General information

NPI: 1407743412
Provider Name (Legal Business Name): NNEKA OGBONNAYA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 UNIVERSITY BLVD
GALVESTON TX
77555-5303
US

IV. Provider business mailing address

301 UNIVERSITY BLVD
GALVESTON TX
77555-5303
US

V. Phone/Fax

Practice location:
  • Phone: 409-772-1011
  • Fax:
Mailing address:
  • Phone: 313-909-7284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: