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General NPI Number Information
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NPI Number | 1396009668
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Entity Type | Individual
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Provider Name | NKECHI EZIRIM M.D
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Gender | Female
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Dates
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Enumeration Date | 07/01/2012
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Last Update Date | 08/18/2024
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Provider Practice Location Address
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Address Line | 420 E 6TH ST
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City | ODESSA
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State | TX
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Zip | 79761-4517
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Country | US
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Telephone | 432-582-8757
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Fax | 432-582-8757
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Provider Business Mailing Address
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Address Line | 420 E 6TH ST
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City | ODESSA
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State | TX
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Zip | 79761-4517
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Country | US
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Telephone | 432-582-8757
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Fax | 432-582-8757
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 125058651
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101255661
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | Q9345
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | Q9345
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License Number State | TX
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