Provider Demographics
NPI:1376805242
Name:RIVERCITY WOMENS HEALTH
Entity Type:Organization
Organization Name:RIVERCITY WOMENS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NKECHI
Authorized Official - Middle Name:
Authorized Official - Last Name:OGOGOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-684-1000
Mailing Address - Street 1:5534 ROGERS ROAD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251
Mailing Address - Country:US
Mailing Address - Phone:210-684-1000
Mailing Address - Fax:210-684-1003
Practice Address - Street 1:5534 ROGERS ROAD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251
Practice Address - Country:US
Practice Address - Phone:210-684-1000
Practice Address - Fax:210-684-1003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX316770201Medicaid
TX316770201Medicaid