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4828 Old Spanish Trl Unit A Houston TX 77021-1721 | |
| (832) 305-5476 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 4828 Old Spanish Trl Unit A, Houston, Texas |
| Authorized Official Name and Position | Oghenejiro Akpobome (OWNER) |
| Authorized Official Contact | 7135025435 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
4828 Old Spanish Trl Unit A Houston TX 77021-1721 Ph: (832) 305-5476 | 4828 Old Spanish Trl Unit A Houston TX 77021-1721 Ph: (832) 305-5476 |
| NPI Number | 1396443594 |
|---|---|
| Provider Enumeration Date | 02/17/2023 |
| Last Update Date | 09/25/2023 |
| Medicare PECOS PAC ID | 1052766029 |
|---|---|
| Medicare Enrollment ID | O20231011000974 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396443594 | NPI | - | NPPES |
| Provider Name | Oghenejiro Akpobome |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1518350248 PECOS PAC ID: 1355654203 Enrollment ID: I20231011001059 |
| Provider Name | Christopher Roclevitch |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1508232992 PECOS PAC ID: 8325347131 Enrollment ID: I20240423001044 |
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