Healthcare Provider Details

I. General information

NPI: 1164437976
Provider Name (Legal Business Name): NEMA IBRAHIM UWAYDAH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 12/12/2019
Certification Date: 12/12/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2636 S LOOP W STE 501
HOUSTON TX
77054-2758
US

IV. Provider business mailing address

2636 S LOOP W STE 501
HOUSTON TX
77054-2758
US

V. Phone/Fax

Practice location:
  • Phone: 713-360-7053
  • Fax: 832-581-3127
Mailing address:
  • Phone: 713-360-7053
  • Fax: 832-581-3127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK8544
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: