Provider Demographics
NPI:1518498476
Name:UZOWULU, IKE UZODINMA (NP)
Entity Type:Individual
Prefix:MR
First Name:IKE
Middle Name:UZODINMA
Last Name:UZOWULU
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7373 ARDMORE ST APT 1352
Mailing Address - Street 2:1352
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-4220
Mailing Address - Country:US
Mailing Address - Phone:281-979-4812
Mailing Address - Fax:
Practice Address - Street 1:7373 ARDMORE ST APT 1352
Practice Address - Street 2:1352
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-4220
Practice Address - Country:US
Practice Address - Phone:281-979-4812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133657363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health