Provider Demographics
NPI:1578703179
Name:OBONORUMA I EKHAESE
Entity Type:Organization
Organization Name:OBONORUMA I EKHAESE
Other - Org Name:C A R E SURGERY CLINIC-PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OBONORUMA
Authorized Official - Middle Name:IMARIABE
Authorized Official - Last Name:EKHAESE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:713-562-2691
Mailing Address - Street 1:PO BOX 891392
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77289-1392
Mailing Address - Country:US
Mailing Address - Phone:832-915-8140
Mailing Address - Fax:
Practice Address - Street 1:10907 MEMORIAL HERMANN DR STE 440
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4114
Practice Address - Country:US
Practice Address - Phone:832-915-8140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9994208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty