Healthcare Provider Details

I. General information

NPI: 1619220043
Provider Name (Legal Business Name): MARYJOY OKWESILI REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2012
Last Update Date: 10/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7457 HARWIN DR SUITE 303E
HOUSTON TX
77036-2018
US

IV. Provider business mailing address

7457 HARWIN DR SUITE 303E
HOUSTON TX
77036-2018
US

V. Phone/Fax

Practice location:
  • Phone: 832-541-3388
  • Fax:
Mailing address:
  • Phone: 832-541-3388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number758783
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: