Provider Demographics
NPI:1730072703
Name:EKA, ANITA OGHENERO
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:OGHENERO
Last Name:EKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 LANTERN BAY LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-8125
Mailing Address - Country:US
Mailing Address - Phone:346-762-8557
Mailing Address - Fax:
Practice Address - Street 1:8118 FRY RD STE 701
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7850
Practice Address - Country:US
Practice Address - Phone:281-815-5033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-25-439735106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician