MEDICARE: MS. AUGUSTA IFEOMA UMENYI NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	650478	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8Y5047	OTHER	TX	BCBSTX

General Provider Information

NPI Number	:	1972780625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AUGUSTA IFEOMA UMENYI NP

Provider Business Mailing Address
First Line	:	4355 HIGHWAY 6 N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-3446
Country	:	US
Telephone Number	:	281-858-4000
Fax Number	:	281-858-4001

Provider Business Practice Location Address
First Line	:	4355 HIGHWAY 6 N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-3446
Country	:	US
Telephone Number	:	281-858-4000
Fax Number	:	281-858-4001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2008
Last Update Date	:	07/09/2014

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