Individual
IJEOMA EDITH MGBARAHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
6565 FANNIN ST, HOUSTON, TX 77030-2703
(832) 208-2973
Mailing address
6565 FANNIN ST, HOUSTON, TX 77030-2703
(832) 208-2973
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP126949
TX
Other
Enumeration date
11/18/2014
Last updated
02/09/2015
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