Provider Demographics
NPI:1497113245
Name:UMOH, FAITH (MPH, RD, LD, CDE)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:UMOH
Suffix:
Gender:F
Credentials:MPH, RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 MEDICAL PLAZA DR STE 330
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3271
Mailing Address - Country:US
Mailing Address - Phone:281-475-2275
Mailing Address - Fax:281-962-3033
Practice Address - Street 1:920 MEDICAL PLAZA DR STE 330
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3271
Practice Address - Country:US
Practice Address - Phone:281-475-2275
Practice Address - Fax:281-962-3033
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-08
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83741133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered