Provider Demographics
NPI:1669238333
Name:ITONYO, OBIAGELI TONIA
Entity type:Individual
Prefix:
First Name:OBIAGELI
Middle Name:TONIA
Last Name:ITONYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 LITTLE GULL DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-7719
Mailing Address - Country:US
Mailing Address - Phone:214-315-7868
Mailing Address - Fax:
Practice Address - Street 1:921 LITTLE GULL DR
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-7719
Practice Address - Country:US
Practice Address - Phone:214-315-7868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other