Provider Demographics
NPI:1619416286
Name:OJONG, OBEN BLAIR
Entity Type:Individual
Prefix:
First Name:OBEN
Middle Name:BLAIR
Last Name:OJONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:OBEN
Other - Middle Name:
Other - Last Name:OJONG-EGBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2120 ASHLAND ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2418
Mailing Address - Country:US
Mailing Address - Phone:713-864-2659
Mailing Address - Fax:
Practice Address - Street 1:2120 ASHLAND ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2418
Practice Address - Country:US
Practice Address - Phone:713-864-2659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-15
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS16148208D00000X
390200000X
TXT1501207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program