Provider Demographics
NPI:1376706366
Name:NEMA I UWAYDAH MD PA
Entity Type:Organization
Organization Name:NEMA I UWAYDAH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEMA
Authorized Official - Middle Name:I
Authorized Official - Last Name:UWAYDAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-236-4976
Mailing Address - Street 1:2636 S LOOP W STE 501
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2758
Mailing Address - Country:US
Mailing Address - Phone:713-360-7053
Mailing Address - Fax:832-581-3127
Practice Address - Street 1:2636 S LOOP W STE 501
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2758
Practice Address - Country:US
Practice Address - Phone:713-360-7053
Practice Address - Fax:832-581-3127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8544207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX162002301OtherTEXAS HEALTH STEP
TX037711103Medicaid