Provider Demographics
NPI:1619220043
Name:OKWESILI, MARYJOY (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:MARYJOY
Middle Name:
Last Name:OKWESILI
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7457 HARWIN DR
Mailing Address - Street 2:SUITE 303E
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2018
Mailing Address - Country:US
Mailing Address - Phone:832-541-3388
Mailing Address - Fax:
Practice Address - Street 1:7457 HARWIN DR
Practice Address - Street 2:SUITE 303E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2018
Practice Address - Country:US
Practice Address - Phone:832-541-3388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX758783163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse