Healthcare Provider Details

I. General information

NPI: 1760278279
Provider Name (Legal Business Name): GLORIA ONYINYECHI OBANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2025
Last Update Date: 04/19/2025
Certification Date: 04/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5819 HIGHWAY 6 STE 360
MISSOURI CITY TX
77459-4070
US

IV. Provider business mailing address

15155 RICHMOND AVE APT 910
HOUSTON TX
77082-1637
US

V. Phone/Fax

Practice location:
  • Phone: 832-514-3863
  • Fax:
Mailing address:
  • Phone: 713-550-0409
  • Fax: 713-550-0409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: