Provider Demographics
NPI:1295402055
Name:ALILONU, IJEOMA
Entity Type:Individual
Prefix:
First Name:IJEOMA
Middle Name:
Last Name:ALILONU
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 1:4603 ORKNEY DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2807
Mailing Address - Country:US
Mailing Address - Phone:240-355-1246
Mailing Address - Fax:
Practice Address - Street 1:4603 ORKNEY DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2807
Practice Address - Country:US
Practice Address - Phone:240-355-1246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1824991363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner