Provider Demographics
NPI:1275172751
Name:OTTEH, IGNATIUS EKENE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:IGNATIUS
Middle Name:EKENE
Last Name:OTTEH
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10039 BISSONNET ST STE 319
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7840
Mailing Address - Country:US
Mailing Address - Phone:877-211-3829
Mailing Address - Fax:877-899-0690
Practice Address - Street 1:10039 BISSONNET ST STE 319
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7840
Practice Address - Country:US
Practice Address - Phone:877-211-3829
Practice Address - Fax:877-899-0690
Is Sole Proprietor?:No
Enumeration Date:2019-12-31
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144477363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32897OtherPRESCRIPTIVE AUTHORIZATION