Healthcare Provider Details

I. General information

NPI: 1992352660
Provider Name (Legal Business Name): MICHAEL AZUBUIKE UWAELUE FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2019
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 WEST LOOP S STE 525
BELLAIRE TX
77401-3519
US

IV. Provider business mailing address

6565 WEST LOOP S STE 525
BELLAIRE TX
77401-3519
US

V. Phone/Fax

Practice location:
  • Phone: 713-661-7888
  • Fax:
Mailing address:
  • Phone: 713-661-7888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number209538
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209538
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP142044
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: