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General NPI Number Information
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NPI Number | 1164893459
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Entity Type | Individual
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Provider Name | HENRIETTA UDUNENWU
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Gender | Female
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Dates
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Enumeration Date | 10/12/2015
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 4126 SOUTHWEST FWY
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City | HOUSTON
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State | TX
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Zip | 77027
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Country | US
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Telephone | 682-727-0175
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 721762
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City | HOUSTON
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State | TX
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Zip | 77272-1762
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Country | US
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Telephone | 214-727-0174
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP128432
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP128432
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 759505
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | TX
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