Provider Demographics
NPI:1639477847
Name:UGBALA, CHINENYE
Entity Type:Individual
Prefix:
First Name:CHINENYE
Middle Name:
Last Name:UGBALA
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 1:14315 TORREY FOREST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1714
Mailing Address - Country:US
Mailing Address - Phone:832-883-9390
Mailing Address - Fax:281-661-8186
Practice Address - Street 1:14315 TORREY FOREST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1714
Practice Address - Country:US
Practice Address - Phone:832-883-9390
Practice Address - Fax:281-661-8186
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-11
Last Update Date:2011-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor