Provider Demographics
NPI:1184861452
Name:ODIGBO, RALPH U
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:U
Last Name:ODIGBO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1258 BLUESTONE DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1522
Mailing Address - Country:US
Mailing Address - Phone:832-368-5533
Mailing Address - Fax:281-403-1313
Practice Address - Street 1:1258 BLUESTONE DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-1522
Practice Address - Country:US
Practice Address - Phone:832-368-5533
Practice Address - Fax:281-403-1313
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program