Healthcare Provider Details

I. General information

NPI: 1114409968
Provider Name (Legal Business Name): CHIAMAKA E UGBALA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2018
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14511 FALLING CREEK DR STE 203
HOUSTON TX
77014-1280
US

IV. Provider business mailing address

14511 FALLING CREEK DR STE 203
HOUSTON TX
77014-1280
US

V. Phone/Fax

Practice location:
  • Phone: 832-404-8965
  • Fax: 281-661-8186
Mailing address:
  • Phone: 832-404-8965
  • Fax: 281-661-8186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: