Provider Demographics
NPI:1467940973
Name:OSUJI, TOCHI A
Entity Type:Individual
Prefix:MRS
First Name:TOCHI
Middle Name:A
Last Name:OSUJI
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 1:1110 E PLEASANT RUN RD
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4202
Mailing Address - Country:US
Mailing Address - Phone:214-454-3637
Mailing Address - Fax:
Practice Address - Street 1:1110 E PLEASANT RUN RD
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4202
Practice Address - Country:US
Practice Address - Phone:214-454-3637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1664481OtherTEXAS DEPARTMENT OF LICENSING AND REGULATION