Individual
MARVISE IJEOMA ODUAGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
305 W COMMERCE ST APT 336, DALLAS, TX 75208-1985
(214) 597-4465
Mailing address
305 W COMMERCE ST APT 336, DALLAS, TX 75208-1985
(214) 597-4465
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
30020
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30020
TEXAS BOARD OF NURSING
TX
Enumeration date
04/19/2019
Last updated
04/19/2019
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