=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811597172
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANDREW OBIOMACHI ONWUEGBU LPC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2020
-----------------------------------------------------
Last Update Date | 04/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 22001 SOUTHWEST FWY STE 125
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77469-7118
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 844-824-8775
-----------------------------------------------------
Fax | 281-648-2200
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 413
-----------------------------------------------------
City | ALIEF
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77411-0413
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-344-5330
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 79730
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 79730
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------