Provider Demographics
NPI:1598466872
Name:IKECHUKWU, PATRICK U (NP)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:U
Last Name:IKECHUKWU
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1125 CYPRESS STATION DR STE B-1
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3055
Mailing Address - Country:US
Mailing Address - Phone:281-586-7880
Mailing Address - Fax:281-580-5061
Practice Address - Street 1:1125 CYPRESS STATION DR STE B-1
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3055
Practice Address - Country:US
Practice Address - Phone:281-586-7880
Practice Address - Fax:281-580-5061
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111256363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health