Healthcare Provider Details

I. General information

NPI: 1649350059
Provider Name (Legal Business Name): ADAEZE OKEKE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6630 DE MOSS DR
HOUSTON TX
77074-5004
US

IV. Provider business mailing address

1636 HAWTHORNE ST APT 1
HOUSTON TX
77006-3716
US

V. Phone/Fax

Practice location:
  • Phone: 713-272-2600
  • Fax: 713-272-5589
Mailing address:
  • Phone: 305-431-9860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL9405
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: