Provider Demographics
NPI:1417198052
Name:UMEORAH, MICHAEL E
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:E
Last Name:UMEORAH
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 1:29 OLD WINDSOR WAY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4143
Mailing Address - Country:US
Mailing Address - Phone:832-574-8056
Mailing Address - Fax:832-243-8917
Practice Address - Street 1:29 OLD WINDSOR WAY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4143
Practice Address - Country:US
Practice Address - Phone:832-574-8056
Practice Address - Fax:832-243-8917
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008333163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679400Medicare PIN