Provider Demographics
NPI:1528568144
Name:OUMA, BENES
Entity Type:Individual
Prefix:
First Name:BENES
Middle Name:
Last Name:OUMA
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 1:11201 BOUDREAUX RD APT 935
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-7566
Mailing Address - Country:US
Mailing Address - Phone:832-931-0822
Mailing Address - Fax:
Practice Address - Street 1:11201 BOUDREAUX RD APT 935
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-7566
Practice Address - Country:US
Practice Address - Phone:832-931-0822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX906941163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse