Provider Demographics
NPI:1093042624
Name:EVULEOCHA, STEPHANIE J (SPECIALIST)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:J
Last Name:EVULEOCHA
Suffix:
Gender:F
Credentials:SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 HAMMERLY BLVD
Mailing Address - Street 2:SUITE# 1803
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-6508
Mailing Address - Country:US
Mailing Address - Phone:832-267-6386
Mailing Address - Fax:713-647-0501
Practice Address - Street 1:8801 HAMMERLY BLVD
Practice Address - Street 2:SUITE# 1803
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-6508
Practice Address - Country:US
Practice Address - Phone:832-267-6386
Practice Address - Fax:713-647-0501
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19673342171M00000X, 174400000X, 372500000X, 372600000X, 3747A0650X, 3747P1801X, 376J00000X
MO10073640374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide
No174400000XOther Service ProvidersSpecialist
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker