Healthcare Provider Details

I. General information

NPI: 1851045678
Provider Name (Legal Business Name): UCHENNA MGBAME
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2022
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8118 SINGING SONNET LN
HOUSTON TX
77072-0130
US

IV. Provider business mailing address

8118 SINGING SONNET LN
HOUSTON TX
77072-0130
US

V. Phone/Fax

Practice location:
  • Phone: 832-767-7683
  • Fax:
Mailing address:
  • Phone: 832-767-7683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: