Healthcare Provider Details

I. General information

NPI: 1669975439
Provider Name (Legal Business Name): NGOZI ULOMA OKORAFOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2018
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 TAUB LOOP
HOUSTON TX
77030-1608
US

IV. Provider business mailing address

1504 TAUB LOOP
HOUSTON TX
77030-1608
US

V. Phone/Fax

Practice location:
  • Phone: 713-798-1750
  • Fax: 713-798-4693
Mailing address:
  • Phone: 713-798-1750
  • Fax: 713-798-4693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberS6268
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberS6268
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: