MEDICARE: UNIVERSAL MEDICAL CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	J2714	TX

General Provider Information

NPI Number	:	1063454684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSAL MEDICAL CLINIC

Provider Business Mailing Address
First Line	:	1006 FEDERAL RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-4804
Country	:	US
Telephone Number	:	713-671-0400
Fax Number	:	713-330-7511

Provider Business Practice Location Address
First Line	:	1006 FEDERAL RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-4804
Country	:	US
Telephone Number	:	713-671-0400
Fax Number	:	713-330-7511

Authorized Official
Title or Position	:	DIRECTOR
Name	:	PETER CHUKWUEMEKA OKOSE
Credential	:	M.D.
Telephone Number	:	713-671-0400

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	07/21/2022

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Directions to “UNIVERSAL MEDICAL CLINIC ” Practice Location

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