Provider Demographics
NPI:1477202240
Name:OJO, ITAI (DO)
Entity Type:Individual
Prefix:
First Name:ITAI
Middle Name:
Last Name:OJO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-6206
Mailing Address - Country:US
Mailing Address - Phone:713-861-3939
Mailing Address - Fax:
Practice Address - Street 1:1100 W 34TH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-6206
Practice Address - Country:US
Practice Address - Phone:713-861-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program