Healthcare Provider Details

I. General information

NPI: 1114769023
Provider Name (Legal Business Name): UKANTI HEALTHCARE SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2024
Last Update Date: 11/02/2024
Certification Date: 11/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2933 PARK PLAZA LN
PORT ARTHUR TX
77642-5516
US

IV. Provider business mailing address

6960 RENO CIR
BEAUMONT TX
77708-3593
US

V. Phone/Fax

Practice location:
  • Phone: 409-234-9888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. NKEM NWAOBI
Title or Position: OWNER
Credential: DNP, FNP-C, PMNHP-BC
Phone: 409-234-9888