Healthcare Provider Details

I. General information

NPI: 1609032531
Provider Name (Legal Business Name): DR. JENNIFER ONAIWU OKOH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ONAIWU OTEZE

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 TAUB LOOP
HOUSTON TX
77030-1608
US

IV. Provider business mailing address

3701 KIRBY DR STE 600
HOUSTON TX
77098-3926
US

V. Phone/Fax

Practice location:
  • Phone: 713-798-4098
  • Fax:
Mailing address:
  • Phone: 713-798-4098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberN1031
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: