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General NPI Number Information
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NPI Number | 1215512462
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Entity Type | Individual
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Provider Name | EBERECHUKWU EZI OLAWALE NP
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Gender | Female
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Dates
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Enumeration Date | 03/09/2021
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 9250 PINECROFT DR
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City | SHENANDOAH
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State | TX
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Zip | 77380-3218
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Country | US
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Telephone | 713-897-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 103 S KNIGHTS CROSSING DR
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City | THE WOODLANDS
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State | TX
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Zip | 77382-1495
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Country | US
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Telephone | 469-387-8849
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1031537
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License Number State | TX
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