=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548524481
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | OBINNA GERALD ONUOHA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2012
-----------------------------------------------------
Last Update Date | 08/08/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6720 BERTNER AVE
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77030-2604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 823-355-2666
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9525 KATY FWY STE 206
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77024-1476
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-400-2990
-----------------------------------------------------
Fax | 713-400-2993
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number | AP122213
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------