Provider Demographics
NPI:1780642488
Name:ARENE, IFEOMA N (MD)
Entity type:Individual
Prefix:DR
First Name:IFEOMA
Middle Name:N
Last Name:ARENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12828 WILLOW CTR
Mailing Address - Street 2:SUITE E
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77066-3043
Mailing Address - Country:US
Mailing Address - Phone:281-893-3656
Mailing Address - Fax:281-893-3464
Practice Address - Street 1:12828 WILLOW CTR
Practice Address - Street 2:SUITE E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-3043
Practice Address - Country:US
Practice Address - Phone:281-893-3656
Practice Address - Fax:281-893-3464
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL52292084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157916104Medicaid
TX312658605OtherUNITED BEHAVIORAL HEALTH
TX01161084OtherAMERIGROUP
TX01161084OtherAMERIGROUP
TX312658605OtherUNITED BEHAVIORAL HEALTH