Provider Demographics
NPI:1598304107
Name:OJI, PAULINE IZUCHUKWU (NP)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:IZUCHUKWU
Last Name:OJI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 FAIRWAY GLEN DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-5559
Mailing Address - Country:US
Mailing Address - Phone:972-814-6387
Mailing Address - Fax:972-814-6387
Practice Address - Street 1:1914 FAIRWAY GLEN DR
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-5559
Practice Address - Country:US
Practice Address - Phone:972-814-6387
Practice Address - Fax:972-814-6387
Is Sole Proprietor?:No
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144053363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily