Provider Demographics
NPI:1730664905
Name:OGLES, IDA ALYSSA LEIGH (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:IDA ALYSSA
Middle Name:LEIGH
Last Name:OGLES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7403 HOLLY COURT EST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-3570
Mailing Address - Country:US
Mailing Address - Phone:409-659-6042
Mailing Address - Fax:
Practice Address - Street 1:5115 FANNIN ST STE 950
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5805
Practice Address - Country:US
Practice Address - Phone:713-493-7700
Practice Address - Fax:281-971-4065
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine