Provider Demographics
NPI:1326272188
Name:OBIE, OGADINMA IJEOMA (MD)
Entity Type:Individual
Prefix:
First Name:OGADINMA
Middle Name:IJEOMA
Last Name:OBIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 710578
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77271-0578
Mailing Address - Country:US
Mailing Address - Phone:281-949-3799
Mailing Address - Fax:
Practice Address - Street 1:8470 HIGHWAY 6 N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2004
Practice Address - Country:US
Practice Address - Phone:281-949-3799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-08
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2747207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1326272188OtherTRICARE SOUTH
TX300292501Medicaid
TX8DF979OtherBCBS-TX
TX300292501Medicaid
TXP01095753Medicare PIN