Provider Demographics
NPI:1821265562
Name:ORJI, MARIAM UJU (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIAM
Middle Name:UJU
Last Name:ORJI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIAM
Other - Middle Name:UJU
Other - Last Name:MBA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1151 N BUCKNER BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3403
Mailing Address - Country:US
Mailing Address - Phone:214-321-3536
Mailing Address - Fax:214-321-3520
Practice Address - Street 1:1151 N BUCKNER BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3403
Practice Address - Country:US
Practice Address - Phone:214-321-3536
Practice Address - Fax:214-321-3520
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9105208600000X
TXBP1-0032097208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3295099Medicaid
TX328915Medicare PIN