Provider Demographics
NPI:1699406322
Name:UZOEWULU, CHIDIEBERE TIMOTHY
Entity Type:Individual
Prefix:
First Name:CHIDIEBERE
Middle Name:TIMOTHY
Last Name:UZOEWULU
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 1:2301 HAYES RD APT 7502
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-6945
Mailing Address - Country:US
Mailing Address - Phone:832-292-6925
Mailing Address - Fax:
Practice Address - Street 1:2301 HAYES RD APT 7502
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6945
Practice Address - Country:US
Practice Address - Phone:832-292-6925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health