Provider Demographics
NPI:1497537930
Name:UDEH, IHUOMA UKO
Entity Type:Individual
Prefix:
First Name:IHUOMA
Middle Name:UKO
Last Name:UDEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26943 CHURCHILL GATE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5237
Mailing Address - Country:US
Mailing Address - Phone:832-921-5087
Mailing Address - Fax:
Practice Address - Street 1:26943 CHURCHILL GATE LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5237
Practice Address - Country:US
Practice Address - Phone:832-921-5087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1138388363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty