Provider Demographics
NPI:1144933227
Name:MUGERWA, ISAAC KIGGUDU
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:KIGGUDU
Last Name:MUGERWA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19007 DENSTONE CLIFF WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3585
Mailing Address - Country:US
Mailing Address - Phone:973-710-7912
Mailing Address - Fax:832-218-5666
Practice Address - Street 1:19007 DENSTONE CLIFF WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-3585
Practice Address - Country:US
Practice Address - Phone:973-710-7912
Practice Address - Fax:832-218-5666
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000OtherNONE