Provider Demographics
NPI:1710737606
Name:UDEZI, UFOMA OMOHEFE
Entity Type:Individual
Prefix:
First Name:UFOMA
Middle Name:OMOHEFE
Last Name:UDEZI
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 1:2955 ALOUETTE DR APT 712
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-8171
Mailing Address - Country:US
Mailing Address - Phone:404-916-2625
Mailing Address - Fax:
Practice Address - Street 1:2955 ALOUETTE DR APT 712
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-8171
Practice Address - Country:US
Practice Address - Phone:404-916-2625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport