Provider Demographics
NPI:1689032617
Name:UKOMADU, NKECHI
Entity Type:Individual
Prefix:
First Name:NKECHI
Middle Name:
Last Name:UKOMADU
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 1:14918 LAKE WOODBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-0900
Mailing Address - Country:US
Mailing Address - Phone:713-391-6863
Mailing Address - Fax:
Practice Address - Street 1:14918 LAKE WOODBRIDGE CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-0900
Practice Address - Country:US
Practice Address - Phone:713-391-6863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-04
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128933363LF0000X, 363LP0808X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty