Provider Demographics
NPI:1528584521
Name:UFFORT SURGICAL PLLC
Entity Type:Organization
Organization Name:UFFORT SURGICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EKONG
Authorized Official - Middle Name:
Authorized Official - Last Name:UFFORT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-295-9245
Mailing Address - Street 1:1050 GEMINI ST STE 202
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2706
Mailing Address - Country:US
Mailing Address - Phone:281-409-7032
Mailing Address - Fax:832-995-0335
Practice Address - Street 1:1050 GEMINI ST STE 202
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2706
Practice Address - Country:US
Practice Address - Phone:832-295-9245
Practice Address - Fax:832-995-0335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-21
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGMedicaid