Provider Demographics
NPI:1013606185
Name:OBIJURU, IJEOMA GLADYS (PMHNP)
Entity type:Individual
Prefix:
First Name:IJEOMA
Middle Name:GLADYS
Last Name:OBIJURU
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 1:16610 CLIFF VALE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-4401
Mailing Address - Country:US
Mailing Address - Phone:713-575-0795
Mailing Address - Fax:
Practice Address - Street 1:17750 CALI DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2700
Practice Address - Country:US
Practice Address - Phone:281-586-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1117413363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health