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General NPI Number Information
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NPI Number | 1871093260
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Entity Type | Individual
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Provider Name | DR. IFEANYI GABRIEL EZEH
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Gender | Male
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Dates
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Enumeration Date | 02/13/2018
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Last Update Date | 05/31/2025
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Provider Practice Location Address
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Address Line | 668 SCARLETT STREET
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City | FORNEY
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State | TX
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Zip | 75126
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Country | US
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Telephone | 956-437-1355
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Fax |
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Provider Business Mailing Address
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Address Line | 668 SCARLETT STREET
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City | FORNEY
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State | TX
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Zip | 75126
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Country | US
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Telephone | 956-437-1355
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 75334
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 75334
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License Number State | TX
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