Provider Demographics
NPI:1649946385
Name:OGBORO, KAREN (NP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:OGBORO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 EDWARDS ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-4277
Mailing Address - Country:US
Mailing Address - Phone:832-206-7884
Mailing Address - Fax:
Practice Address - Street 1:1212 EDWARDS ST UNIT C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-4277
Practice Address - Country:US
Practice Address - Phone:832-206-7884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-22
Last Update Date:2021-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1050105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty