Provider Demographics
NPI:1801614151
Name:ONUOHA, INNOCENT EZEKWESIRI
Entity type:Individual
Prefix:
First Name:INNOCENT
Middle Name:EZEKWESIRI
Last Name:ONUOHA
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 1:1104 COACHES XING
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3964
Mailing Address - Country:US
Mailing Address - Phone:512-417-0708
Mailing Address - Fax:
Practice Address - Street 1:1104 COACHES XING
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3964
Practice Address - Country:US
Practice Address - Phone:512-417-0708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1149009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily