Provider Demographics
NPI:1760956015
Name:UKOHA, DOROTHY E
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:E
Last Name:UKOHA
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 1:1704 TAMARACK DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-8176
Mailing Address - Country:US
Mailing Address - Phone:469-834-5766
Mailing Address - Fax:888-320-0905
Practice Address - Street 1:1704 TAMARACK DR
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-8176
Practice Address - Country:US
Practice Address - Phone:469-834-5766
Practice Address - Fax:888-320-0905
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX374U00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty