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General NPI Number Information
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NPI Number | 1063788636
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Entity Type | Individual
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Provider Name | IRABOR IDENOBE OKOGBO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2012
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Last Update Date | 05/01/2018
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Provider Practice Location Address
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Address Line | 8190 BARKER CYPRESS RD. SUITE 200
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City | CYPRESS
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State | TX
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Zip | 77433
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Country | US
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Telephone | 832-674-4932
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Fax | 832-906-6212
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Provider Business Mailing Address
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Address Line | 8190 BARKER CYPRESS RD. SUITE 200
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City | CYPRESS
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State | TX
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Zip | 77433
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Country | US
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Telephone | 832-674-4932
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Fax | 832-906-6212
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 27752
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License Number State | TX
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