Organization
NORTHSIDE PEDIATRICS ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL E OKOGBO M.D. (OWNER)
(806) 626-3808
Entity
Organization
Contact information
Practice address
15210 I-45 SOUTH, SUITE 110, CONROE, TX 77384-4105
(936) 270-8655
Mailing address
15210 I-45 S, 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
01
—
1043224132
NPI
TX
01
—
1609104785
NPI
TX
Enumeration date
08/28/2016
Last updated
04/19/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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