Healthcare Provider Details

I. General information

NPI: 1578127718
Provider Name (Legal Business Name): ONYINYECHI VANESSA EVOH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VANESSA EVOH MD

II. Dates (important events)

Enumeration Date: 04/23/2019
Last Update Date: 10/27/2024
Certification Date: 10/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 FANNIN ST
HOUSTON TX
77030-2703
US

IV. Provider business mailing address

PO BOX 3158
PORTLAND OR
97208-3158
US

V. Phone/Fax

Practice location:
  • Phone: 713-441-0428
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPG193590
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberU5953
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberU5953
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: