Healthcare Provider Details

I. General information

NPI: 1225472939
Provider Name (Legal Business Name): ADAMMA NNENNA OKORAFOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 HOLCOMBE BLVD
HOUSTON TX
77030
US

IV. Provider business mailing address

6550 FANNIN ST STE 2509
HOUSTON TX
77030-2777
US

V. Phone/Fax

Practice location:
  • Phone: 713-791-1414
  • Fax:
Mailing address:
  • Phone: 346-238-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberR8252
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR8252
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: