Provider Demographics
NPI:1689203192
Name:EZEKOR, MAUREEN (MD)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:EZEKOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18980 N MEMORIAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4498
Mailing Address - Country:US
Mailing Address - Phone:281-707-6400
Mailing Address - Fax:281-584-6432
Practice Address - Street 1:18980 N MEMORIAL DR STE 200
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4498
Practice Address - Country:US
Practice Address - Phone:281-707-6400
Practice Address - Fax:281-584-6432
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV1766207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology