Provider Demographics
NPI:1679990360
Name:OKOBA, NGOZI (MD)
Entity type:Individual
Prefix:DR
First Name:NGOZI
Middle Name:
Last Name:OKOBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:NGOZICHUKWUKA
Other - Middle Name:
Other - Last Name:OKOBA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 412880
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2880
Mailing Address - Country:US
Mailing Address - Phone:610-644-8900
Mailing Address - Fax:484-924-0053
Practice Address - Street 1:8015 N EXPRESSWAY 77
Practice Address - Street 2:
Practice Address - City:OLMITO
Practice Address - State:TX
Practice Address - Zip Code:78575-5171
Practice Address - Country:US
Practice Address - Phone:956-982-4484
Practice Address - Fax:956-982-4489
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS103207RN0300X
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology