# INNOVATIVE PRIMARY CARE PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912610353
- **Authorized official:** DR. NNEKA UZOAMAKA EDOKPAYI MD (MEDICAL DIRECTORY)
- **Authorized official phone:** (202) 492-8519

## Contact information

- **Practice address:** 17070 RED OAK DR STE 309, HOUSTON, TX 77090-2616
- **Practice address phone:** (281) 207-0461
- **Practice address fax:** (888) 273-0398
- **Mailing address:** 118 ELDRIDGE RD STE A, SUGAR LAND, TX 77478-4695
- **Mailing address phone:** (832) 564-3526
- **Mailing address fax:** (888) 273-0398

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133VN1201X | Obesity and Weight Management Nutrition Registered Dietitian | — | NULL | — |
| 133VN1201X | Obesity and Weight Management Nutrition Registered Dietitian | — | — | — |
| 163WW0000X | Wound Care Registered Nurse | — | NULL | — |
| 163WW0000X | Wound Care Registered Nurse | — | — | — |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0000X | Adolescent Medicine (Internal Medicine) Physician | — | — | Yes |
| 2083B0002X | Obesity Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083B0002X | Obesity Medicine (Preventive Medicine) Physician | — | — | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | NULL | — |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 12/30/2022
- **Last updated:** 09/07/2023