Healthcare Provider Details

I. General information

NPI: 1497945703
Provider Name (Legal Business Name): ULOMA EZI AKANWA RN,MSN,FNP,BCCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ULOMA EZI AKANWA RN,MSN,FNP,BCCS

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 03/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14718 RICH VALLEY LN
SUGAR LAND TX
77478-5031
US

IV. Provider business mailing address

14718 RICH VALLEY LN
SUGAR LAND TX
77478-5031
US

V. Phone/Fax

Practice location:
  • Phone: 832-256-4483
  • Fax:
Mailing address:
  • Phone: 832-256-4483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number579606
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: