MARVISE IJEOMA ODUAGU


Address: 305 W Commerce St Apt 336, Dallas, TX 75208-1985
Phone: 2145974465

MARVISE IJEOMA ODUAGU (NPI# 1679136220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679136220
Entity Type Individual
Full Name MARVISE IJEOMA ODUAGU
Practice Address 305 W Commerce St Apt 336
Dallas
TX 75208-1985
Practice Telephone 2145974465
Mailing Telephone 2145974465
Enumeration Date 2019-04-19
Last Update Date 2019-04-19
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2100X Nurse Practitioner
Specialization: Acute Care
30020 TX Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
TX TEXAS BOARD OF NURSING 30020 01

Office Location

Street Address 305 W COMMERCE ST APT 336
City DALLAS
State TX
Zip Code 75208-1985

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1477023430 Amber M James Dmd, Pllc Dentist 650 Fort Worth Ave, Ste 130, Dallas, TX 75208 2018-12-03
1659841237 Andrea Pavia-jimenez Physician Assistant 817 Jefferson Blvd, Dallas, TX 75208 2018-11-27
1841716859 Jennifer Atherton Midwife 618 S Rosemont Ave, Dallas, TX 75208 2017-08-22
1659815892 Texas Traumatic Brain Injury Rehab Counselor 214 W. Colorado Blvd., Dallas, TX 75208 2016-12-07
1295120111 Silva Pharmacy, Inc Pharmacy 939 W Jefferson Blvd Ste 101, Dallas, TX 75208 2015-03-30
1487052478 Kassandra Sanchez Counselor 210 West 10th Street, Dallas, TX 75208 2014-12-08
1023458650 O.c Medical Associates Pa Internal Medicine 737 N. Bishop Avenue, Ste B, Dallas, TX 75208 2013-06-27
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Taxonomy Information

Taxonomy Code 363LA2100X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Acute Care

Taxonomy Definition

Definition to come...

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1366090417 Maria Whitney Nance Nurse Practitioner 7777 Forest Ln Ste D308, Dallas, TX 75230-2571 2019-09-02
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1851860365 Yoon Jung Ra Nurse Practitioner 2610 Allen St Apt 5410, Dallas, TX 75204-2447 2018-11-14
1134696453 Mitchell Grayson Kelly Nurse Practitioner 5323 Harry Hines Blvd Mailcode 8590, Dallas, TX 75390-0001 2018-10-24
1710411822 Latosca Brunner Nurse Practitioner 221 W Beckley Blvd, Pavilion 2 Suite 929, Dallas, TX 75202 2017-04-14
1376900746 Lashandra Gray Nurse Practitioner 9111 Prairie Bluff Dr, Dallas, TX 75227-5245 2016-01-15
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Competitor

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City DALLAS
Zip Code 75208

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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