Provider Demographics
NPI:1316025539
Name:PUGMAN, INC
Entity Type:Organization
Organization Name:PUGMAN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN-ADM
Authorized Official - Prefix:MS
Authorized Official - First Name:UGO
Authorized Official - Middle Name:CHINYERE
Authorized Official - Last Name:UWAKA
Authorized Official - Suffix:
Authorized Official - Credentials:BSN-RN
Authorized Official - Phone:210-289-1582
Mailing Address - Street 1:9515 CANTURA CRST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-1717
Mailing Address - Country:US
Mailing Address - Phone:210-289-1582
Mailing Address - Fax:210-680-1180
Practice Address - Street 1:9515 CANTURA CRST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-1717
Practice Address - Country:US
Practice Address - Phone:210-289-1582
Practice Address - Fax:210-680-1180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009747251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1884322Medicaid
TX1884322Medicaid