Provider Demographics
NPI:1457729287
Name:OBAZE, DORIS ADEDIWURA (FNP)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:ADEDIWURA
Last Name:OBAZE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15415 WAUMSLEY WAY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7573
Mailing Address - Country:US
Mailing Address - Phone:713-205-7328
Mailing Address - Fax:713-777-5034
Practice Address - Street 1:15415 WAUMSLEY WAY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7573
Practice Address - Country:US
Practice Address - Phone:713-205-7328
Practice Address - Fax:713-777-5034
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128761363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily