Healthcare Provider Details

I. General information

NPI: 1679104707
Provider Name (Legal Business Name): UFUOMA OLOKPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2020
Last Update Date: 11/27/2023
Certification Date: 01/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5656 KELLEY ST
HOUSTON TX
77026-1967
US

IV. Provider business mailing address

6343 BIG OAK CANYON DR
RICHMOND TX
77469-6278
US

V. Phone/Fax

Practice location:
  • Phone: 713-566-4490
  • Fax:
Mailing address:
  • Phone: 832-755-1842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number885799
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: