Provider Demographics
NPI:1336670199
Name:UGA, CECILIA O (NP)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:O
Last Name:UGA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6224 CALLE LISA WAY
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7542
Mailing Address - Country:US
Mailing Address - Phone:832-206-9229
Mailing Address - Fax:
Practice Address - Street 1:2022 MURCHISON DR STE 108
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3058
Practice Address - Country:US
Practice Address - Phone:915-200-1144
Practice Address - Fax:915-703-7668
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX888839163W00000X
TXAP144146363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse