Provider Demographics
NPI:1295435576
Name:OGBEIDE, HENRY
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:OGBEIDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 FAIRMONT LN
Mailing Address - Street 2:
Mailing Address - City:HEARTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75126-3531
Mailing Address - Country:US
Mailing Address - Phone:817-704-9869
Mailing Address - Fax:
Practice Address - Street 1:4005 FAIRMONT LN
Practice Address - Street 2:
Practice Address - City:HEARTLAND
Practice Address - State:TX
Practice Address - Zip Code:75126-3531
Practice Address - Country:US
Practice Address - Phone:817-704-9869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral