Healthcare Provider Details

I. General information

NPI: 1093881203
Provider Name (Legal Business Name): DANIELA UCHECHUKWU USIFOH DDS., MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. DANIELA UCHECHUKWU ADEOLA

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 BINZ ST 1380
HOUSTON TX
77004-6900
US

IV. Provider business mailing address

1200 BINZ ST 1380
HOUSTON TX
77004-6900
US

V. Phone/Fax

Practice location:
  • Phone: 713-520-8400
  • Fax: 713-520-7773
Mailing address:
  • Phone: 713-520-8400
  • Fax: 713-520-7773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number22078
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: