Healthcare Provider Details

I. General information

NPI: 1578865234
Provider Name (Legal Business Name): MR. SUNDAY UWAH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2010
Last Update Date: 11/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 WATERWAY DR
MESQUITE TX
75181-1881
US

IV. Provider business mailing address

2221 WATERWAY DR
MESQUITE TX
75181-1881
US

V. Phone/Fax

Practice location:
  • Phone: 214-235-1117
  • Fax:
Mailing address:
  • Phone: 214-235-1117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: