Provider Demographics
NPI:1578127718
Name:EVOH, ONYINYECHI VANESSA (MD)
Entity Type:Individual
Prefix:
First Name:ONYINYECHI
Middle Name:VANESSA
Last Name:EVOH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:EVOH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3158
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3158
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 HARBORSIDE DR
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-2985
Practice Address - Country:US
Practice Address - Phone:409-772-3373
Practice Address - Fax:409-747-7014
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPG193590390200000X
TXU5953207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine