Basic Information
Provider Information | |||||||||
NPI: | 1861975740 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | AKAHIEOBI | ||||||||
FirstName: | AUGUSTINA | ||||||||
MiddleName: | IJOMA | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | RN,BSN | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | BAUGH | ||||||||
OtherFirstName: | AUGUSTINA | ||||||||
OtherMiddleName: | ULEKWU | ||||||||
OtherNamePrefix: | MRS. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 5 | ||||||||
Mailing Information | |||||||||
Address1: | 19822 SEAGLER GLEN LN | ||||||||
Address2: |   | ||||||||
City: | KATY | ||||||||
State: | TX | ||||||||
PostalCode: | 774494149 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7134295718 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 2424 WILCREST DR | ||||||||
Address2: |   | ||||||||
City: | HOUSTON | ||||||||
State: | TX | ||||||||
PostalCode: | 770422761 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7136668287 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/07/2018 | ||||||||
LastUpdateDate: | 09/07/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WH0200X | 835300 | TX | Y |   | Nursing Service Providers | Registered Nurse | Home Health |
No ID Information.