Healthcare Provider Details

I. General information

NPI: 1255200465
Provider Name (Legal Business Name): THE UDOFIA CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9550 MEYER FOREST DR APT 242
HOUSTON TX
77096-4344
US

IV. Provider business mailing address

9550 MEYER FOREST DR APT 242
HOUSTON TX
77096-4344
US

V. Phone/Fax

Practice location:
  • Phone: 903-262-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH AKANINYENE UDOFIA
Title or Position: OWNER
Credential: PT, DPT
Phone: 903-262-4800