Individual
MRS. IZEHIESE IMUWAHEN OBANOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2419 FAIRBREEZE DR, KATY, TX 77494-5103
(832) 392-1029
Mailing address
2419 FAIRBREEZE DR, KATY, TX 77494-5103
(832) 392-1029
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
797980
TX
Other
Enumeration date
02/27/2012
Last updated
02/27/2012
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