Provider Demographics
NPI:1902243306
Name:OHANAJA, JUDE ANOSIRIONYE
Entity Type:Individual
Prefix:MR
First Name:JUDE
Middle Name:ANOSIRIONYE
Last Name:OHANAJA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6435 W RIDGECREEK DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-2823
Mailing Address - Country:US
Mailing Address - Phone:832-868-4640
Mailing Address - Fax:
Practice Address - Street 1:6435 W RIDGECREEK DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-2823
Practice Address - Country:US
Practice Address - Phone:832-868-4640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-27
Last Update Date:2013-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXA00854166172V00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No172V00000XOther Service ProvidersCommunity Health Worker