Healthcare Provider Details

I. General information

NPI: 1225429178
Provider Name (Legal Business Name): UCHE OBUTE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2015
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14123 BEECH GLEN DR
HOUSTON TX
77083-5860
US

IV. Provider business mailing address

14123 BEECH GLEN DR
HOUSTON TX
77083-5860
US

V. Phone/Fax

Practice location:
  • Phone: 832-441-7184
  • Fax:
Mailing address:
  • Phone: 832-441-7184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: