MEDICARE: DR. JANE UJOATU DRPH, RDN/LDN

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	133V00000X	Registered Dietitian	DT84360	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	812104530	OTHER		IRS

General Provider Information

NPI Number	:	1164975173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE UJOATU DRPH, RDN/LDN

Provider Business Mailing Address
First Line	:	5614 W GRAND PKWY S STE 102
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-5820
Country	:	US
Telephone Number	:	832-594-0756
Fax Number	:	281-533-8274

Provider Business Practice Location Address
First Line	:	5614 W GRAND PKWY S STE 102
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-5820
Country	:	US
Telephone Number	:	832-594-0756
Fax Number	:	281-533-8274

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2016
Last Update Date	:	12/20/2024

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