Provider Demographics
NPI:1376211243
Name:OBUEKWE, UDEZUE O
Entity Type:Individual
Prefix:
First Name:UDEZUE
Middle Name:O
Last Name:OBUEKWE
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 1:2615 SKYVIEW SILVER DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-5159
Mailing Address - Country:US
Mailing Address - Phone:866-827-1941
Mailing Address - Fax:346-279-0621
Practice Address - Street 1:2615 SKYVIEW SILVER DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-5159
Practice Address - Country:US
Practice Address - Phone:866-827-1941
Practice Address - Fax:346-279-0621
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-03
Last Update Date:2021-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide