Healthcare Provider Details

I. General information

NPI: 1750687562
Provider Name (Legal Business Name): OGECHI N UKEGBU O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2011
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 WESTHEIMER RD STE 180
HOUSTON TX
77063
US

IV. Provider business mailing address

8401 WESTHEIMER RD STE 180
HOUSTON TX
77063-2708
US

V. Phone/Fax

Practice location:
  • Phone: 281-944-8864
  • Fax:
Mailing address:
  • Phone: 281-944-8864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number8263T
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTPOP96
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3244
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT003491
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTA2219
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: