Provider Demographics
NPI:1104355999
Name:UBOM, EMEMOBONG OFFIONG (MD)
Entity Type:Individual
Prefix:DR
First Name:EMEMOBONG
Middle Name:OFFIONG
Last Name:UBOM
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 1:1601 LIBERTY ST STE A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3252
Mailing Address - Country:US
Mailing Address - Phone:281-342-6962
Mailing Address - Fax:281-342-6963
Practice Address - Street 1:1601 LIBERTY ST STE A
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3252
Practice Address - Country:US
Practice Address - Phone:281-342-6962
Practice Address - Fax:281-342-6963
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXS9237207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program