Provider Demographics
NPI:1619641107
Name:ONWUKWE, FAVOUR (PMHNP)
Entity Type:Individual
Prefix:
First Name:FAVOUR
Middle Name:
Last Name:ONWUKWE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8030 FM 1765 STE G-102
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-3689
Mailing Address - Country:US
Mailing Address - Phone:281-694-4758
Mailing Address - Fax:
Practice Address - Street 1:8030 FM 1765 STE G-102
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-3689
Practice Address - Country:US
Practice Address - Phone:281-694-4758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1032194363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health