Provider Demographics
NPI:1639155815
Name:UBESIE, KANAYO E (MD)
Entity Type:Individual
Prefix:DR
First Name:KANAYO
Middle Name:E
Last Name:UBESIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7737 SOUTHWEST FWY
Mailing Address - Street 2:STE 819
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1807
Mailing Address - Country:US
Mailing Address - Phone:713-773-1700
Mailing Address - Fax:832-200-2103
Practice Address - Street 1:7737 SOUTHWEST FWY
Practice Address - Street 2:STE 819
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1807
Practice Address - Country:US
Practice Address - Phone:713-773-1700
Practice Address - Fax:832-200-2103
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6670207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121046003Medicaid
TX121046001Medicaid
TXH71WOtherBCBS
TX121046001Medicaid
TX121046003Medicaid