Individual
MICHAEL EBHOTA OKOGBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15210 I-45 S, SUITE 110, CONROE, TX 77384-4105
(936) 270-8655
(936) 270-8739
Mailing address
15210 I-45 SOUTH, SUITE 110, CONROE, TX 77384-4105
(936) 270-8655
(936) 270-8739
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K4516
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125748707
—
TX
01
—
125748708
CSHCN
TX
05
—
200134400 A
—
OK
05
—
67022383
—
NM
Enumeration date
07/27/2006
Last updated
04/28/2017
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