Provider Demographics
NPI:1730314642
Name:OMORIGIE DAVIES, ROSE
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:OMORIGIE DAVIES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NA
Other - Middle Name:
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16331 DRYBERRY CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-5182
Mailing Address - Country:US
Mailing Address - Phone:832-259-7555
Mailing Address - Fax:186-633-6747
Practice Address - Street 1:16331 DRYBERRY CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-5182
Practice Address - Country:US
Practice Address - Phone:832-259-7555
Practice Address - Fax:186-633-6747
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013227251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health