Provider Demographics
NPI:1407044431
Name:ONIGU-OTITE, EDORE CELESTINA (MB;BS)
Entity Type:Individual
Prefix:
First Name:EDORE
Middle Name:CELESTINA
Last Name:ONIGU-OTITE
Suffix:
Gender:F
Credentials:MB;BS
Other - Prefix:
Other - First Name:EDORE
Other - Middle Name:CELESTINA
Other - Last Name:ONIGU-OTITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MB;BS
Mailing Address - Street 1:1977 BUTLER BLVD STE E4.400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4101
Mailing Address - Country:US
Mailing Address - Phone:713-798-3830
Mailing Address - Fax:
Practice Address - Street 1:1504 TAUB LOOP
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1608
Practice Address - Country:US
Practice Address - Phone:713-873-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM97742084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry