Provider Demographics
NPI:1063677672
Name:AGUORU, OKEZIE (MD)
Entity Type:Individual
Prefix:
First Name:OKEZIE
Middle Name:
Last Name:AGUORU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1626
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77410-1626
Mailing Address - Country:US
Mailing Address - Phone:713-796-9500
Mailing Address - Fax:713-796-9504
Practice Address - Street 1:3003 S LOOP W STE 204
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1371
Practice Address - Country:US
Practice Address - Phone:713-796-9500
Practice Address - Fax:713-796-9504
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0067827207Q00000X
TXN6131207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB125927Medicare PIN