Provider Demographics
NPI:1225510613
Name:OGBONNA, ASIM (RN)
Entity Type:Individual
Prefix:
First Name:ASIM
Middle Name:
Last Name:OGBONNA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14950 HEATHROW FOREST PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77032-3845
Mailing Address - Country:US
Mailing Address - Phone:281-921-2301
Mailing Address - Fax:
Practice Address - Street 1:16714 VILLAGE VIEW TRL
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7200
Practice Address - Country:US
Practice Address - Phone:183-235-9693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX806600163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health