Provider Demographics
NPI:1093770174
Name:UMEH, UCHENNA LIZMAY (MD)
Entity Type:Individual
Prefix:DR
First Name:UCHENNA
Middle Name:LIZMAY
Last Name:UMEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3066 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78220-1013
Mailing Address - Country:US
Mailing Address - Phone:210-233-7062
Mailing Address - Fax:210-434-1704
Practice Address - Street 1:10002 WESTOVER BLUFF
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-9619
Practice Address - Country:US
Practice Address - Phone:210-233-7000
Practice Address - Fax:210-277-5199
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20696208000000X
TXQ1523208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX341033402Medicaid
SCT4817Medicaid
TX341033402Medicaid
SCT4817Medicaid