Provider Demographics
NPI:1033763891
Name:OKEZIE, PETRONILLA UGOCHI (RN)
Entity Type:Individual
Prefix:
First Name:PETRONILLA
Middle Name:UGOCHI
Last Name:OKEZIE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:PETRONILLA
Other - Middle Name:UGOCHI
Other - Last Name:OKEZIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9894 BISSONNET ST STE 394
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8241
Mailing Address - Country:US
Mailing Address - Phone:832-831-8879
Mailing Address - Fax:
Practice Address - Street 1:9894 BISSONNET ST STE 394
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8241
Practice Address - Country:US
Practice Address - Phone:832-831-8879
Practice Address - Fax:832-831-8879
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX948755171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator