Provider Demographics
NPI:1922516491
Name:NNAJIOFOR, LOLOCHINYERE FIDELIA (PHD HEALTH SERVICES)
Entity Type:Individual
Prefix:DR
First Name:LOLOCHINYERE
Middle Name:FIDELIA
Last Name:NNAJIOFOR
Suffix:
Gender:F
Credentials:PHD HEALTH SERVICES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 PROVIDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-9395
Mailing Address - Country:US
Mailing Address - Phone:956-570-1763
Mailing Address - Fax:
Practice Address - Street 1:3100 PROVIDENCE AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-9395
Practice Address - Country:US
Practice Address - Phone:956-570-1763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171W00000X, 172V00000X, 390200000X
TX001022049372500000X
373H00000X
TX001028013372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No171W00000XOther Service ProvidersContractor
No172V00000XOther Service ProvidersCommunity Health Worker
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX811832681Medicaid
TX455597717Medicaid