MEDICARE: DR. MEREDITH ADAORA OKWESILI M.D.

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	390200000X	Student in an Organized Health Care Education/Training Program
2	2084P0800X	Psychiatry Physician	4301111542	MI
3	2084P0800X	Psychiatry Physician	275509	MA
4	2084P0800X	Psychiatry Physician	R9829	TX

General Provider Information

NPI Number	:	1932553120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEREDITH ADAORA OKWESILI M.D.

Provider Business Mailing Address
First Line	:	1127 ELDRIDGE PKWY STE 300398
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-1771
Country	:	US
Telephone Number	:	617-259-8556
Fax Number	:

Provider Business Practice Location Address
First Line	:	1127 ELDRIDGE PKWY STE 300398
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-1771
Country	:	US
Telephone Number	:	617-259-8556
Fax Number	:

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

Provider Enumeration Date	:	04/14/2016
Last Update Date	:	04/17/2026

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