Healthcare Provider Details

I. General information

NPI: 1487402483
Provider Name (Legal Business Name): BRENDA OGBEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7123 SUN VILLAGE DR
HOUSTON TX
77083-7389
US

IV. Provider business mailing address

7123 SUN VILLAGE DR
HOUSTON TX
77083-7389
US

V. Phone/Fax

Practice location:
  • Phone: 832-755-4954
  • Fax:
Mailing address:
  • Phone: 832-755-4954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: