Healthcare Provider Details

I. General information

NPI: 1700552445
Provider Name (Legal Business Name): NGOZI OKOCHA PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2021
Last Update Date: 08/23/2021
Certification Date: 07/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5314 DASHWOOD DR
HOUSTON TX
77081-4603
US

IV. Provider business mailing address

8107 TOPROCK LN
CYPRESS TX
77433-6278
US

V. Phone/Fax

Practice location:
  • Phone: 713-600-9500
  • Fax:
Mailing address:
  • Phone: 832-272-5567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1045209
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: