MEDICARE: MR. IKE UZODINMA UZOWULU NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	95008181	CA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP133657	TX

General Provider Information

NPI Number	:	1518498476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. IKE UZODINMA UZOWULU NP

Provider Business Mailing Address
First Line	:	7373 ARDMORE ST APT 1352
Second Line	:	1352
City	:	HOUSTON
State	:	TX
Zip	:	77054-4220
Country	:	US
Telephone Number	:	281-979-4812
Fax Number	:

Provider Business Practice Location Address
First Line	:	7373 ARDMORE ST APT 1352
Second Line	:	1352
City	:	HOUSTON
State	:	TX
Zip	:	77054-4220
Country	:	US
Telephone Number	:	281-979-4812
Fax Number	:

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

Provider Enumeration Date	:	03/22/2017
Last Update Date	:	04/28/2026

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