MEDICARE: ELLEN ONWUKA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	315269	TX

General Provider Information

NPI Number	:	1619449667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN ONWUKA

Provider Business Mailing Address
First Line	:	16303 IMPERIAL VALLEY DR APT 815
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-3536
Country	:	US
Telephone Number	:	713-367-5434
Fax Number	:

Provider Business Practice Location Address
First Line	:	16303 IMPERIAL VALLEY DR APT 815
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77060-3536
Country	:	US
Telephone Number	:	713-367-5434
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2018
Last Update Date	:	12/31/2018

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Directions to “ ELLEN ONWUKA ” Practice Location

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