Provider Demographics
NPI:1225135213
Name:OGADI, VINCENT
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:
Last Name:OGADI
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 1:6610 HARWIN DR
Mailing Address - Street 2:SUITE #118
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2232
Mailing Address - Country:US
Mailing Address - Phone:713-532-4199
Mailing Address - Fax:713-532-4197
Practice Address - Street 1:6610 HARWIN DR
Practice Address - Street 2:SUITE #118
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2232
Practice Address - Country:US
Practice Address - Phone:713-532-4199
Practice Address - Fax:713-532-4197
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0065088332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1569360Medicaid
TX1569360Medicaid