Healthcare Provider Details

I. General information

NPI: 1902152796
Provider Name (Legal Business Name): MARY U UKENI FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2012
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16815 WHITAKER CREEK DR
HOUSTON TX
77095-7304
US

IV. Provider business mailing address

16815 WHITAKER CREEK DR
HOUSTON TX
77095-7304
US

V. Phone/Fax

Practice location:
  • Phone: 281-858-0169
  • Fax:
Mailing address:
  • Phone: 281-858-0169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number747829
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: