Provider Demographics
NPI:1780577452
Name:MGBAH, ONYINYECHI (RN)
Entity type:Individual
Prefix:
First Name:ONYINYECHI
Middle Name:
Last Name:MGBAH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18383 PRESTON RD STE 202
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5487
Mailing Address - Country:US
Mailing Address - Phone:404-852-3399
Mailing Address - Fax:
Practice Address - Street 1:18383 PRESTON RD STE 202
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5487
Practice Address - Country:US
Practice Address - Phone:404-852-3399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133NN1002X, 174H00000X, 246RP1900X
TN235581163WC1500X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No174H00000XOther Service ProvidersHealth Educator
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy