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General NPI Number Information
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NPI Number | 1790289734
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Entity Type | Individual
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Provider Name | LLOYD OGHOGHO
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Gender | Male
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 17630 MANCHESTER POINT LN
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City | RICHMOND
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State | TX
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Zip | 77407-2091
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Country | US
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Telephone | 832-607-9375
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Fax |
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Provider Business Mailing Address
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Address Line | 17630 MANCHESTER POINT LN
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City | RICHMOND
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State | TX
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Zip | 77407-2091
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Country | US
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Telephone |
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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 | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 941119
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License Number State | TX
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