MEDICARE: THE UDOFIA CLINIC, PLLC

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1255200465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE UDOFIA CLINIC, PLLC

Provider Business Mailing Address
First Line	:	23550 NORTHGATE CROSSING BLVD APT 102
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-1403
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	23550 NORTHGATE CROSSING BLVD APT 102
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-1403
Country	:	US
Telephone Number	:	903-262-4800
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSEPH AKANINYENE UDOFIA
Credential	:	PT, DPT
Telephone Number	:	903-262-4800

Provider Enumeration Date	:	11/04/2025
Last Update Date	:	05/01/2026

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