Healthcare Provider Details

I. General information

NPI: 1154956811
Provider Name (Legal Business Name): MRS. ANNASTECIA CHINASA OKIBE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNASTECIA CHINASA OKIBE D,O

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4810 RIVERSTONE BLVD STE 100
MISSOURI CITY TX
77459-4092
US

IV. Provider business mailing address

4810 RIVERSTONE BLVD
MISSOURI CITY TX
77459-4092
US

V. Phone/Fax

Practice location:
  • Phone: 713-741-5050
  • Fax:
Mailing address:
  • Phone: 832-916-2677
  • Fax: 832-802-6163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberAP144912
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberAP144912
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: