Provider Demographics
NPI:1114169109
Name:OHAKWE, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:OHAKWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 CAMERON WAY
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-4404
Mailing Address - Country:US
Mailing Address - Phone:214-500-2416
Mailing Address - Fax:469-726-0185
Practice Address - Street 1:2744 CAMERON WAY
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-4404
Practice Address - Country:US
Practice Address - Phone:214-500-2416
Practice Address - Fax:469-726-0185
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker