Provider Demographics
NPI:1275013336
Name:ASEMOTA, UYIOGHOSA ALBERT (MBBS)
Entity Type:Individual
Prefix:DR
First Name:UYIOGHOSA
Middle Name:ALBERT
Last Name:ASEMOTA
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6110 WAGGONER ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:TX
Mailing Address - Zip Code:75462-6239
Mailing Address - Country:US
Mailing Address - Phone:929-386-9397
Mailing Address - Fax:
Practice Address - Street 1:1055 CLARKSVILLE ST STE 200
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-6000
Practice Address - Country:US
Practice Address - Phone:903-737-3204
Practice Address - Fax:866-644-3963
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT3918207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine