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General NPI Number Information
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NPI Number | 1346692589
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Entity Type | Individual
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Provider Name | CONSTANCE CHINYERE EJISMEKWU SLP
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Gender | Female
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Dates
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Enumeration Date | 07/12/2016
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 2401 FOUNTAIN VIEW DR STE 464 PMB2112
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City | HOUSTON
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State | TX
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Zip | 77057-4819
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Country | US
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Telephone | 832-786-1524
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Fax | 832-747-5410
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Provider Business Mailing Address
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Address Line | 2401 FOUNTAIN VIEW DR STE 464 PMB2112
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City | HOUSTON
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State | TX
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Zip | 77057-4819
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Country | US
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Telephone | 832-786-1524
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Fax | 832-747-5410
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 109275
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License Number State | TX
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