Provider Demographics
NPI:1902929003
Name:UGWU, EDITH
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:
Last Name:UGWU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9427 VICKIJOHN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-1734
Mailing Address - Country:US
Mailing Address - Phone:832-368-7194
Mailing Address - Fax:713-771-1095
Practice Address - Street 1:9427 VICKIJOHN DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-1734
Practice Address - Country:US
Practice Address - Phone:832-368-7194
Practice Address - Fax:713-776-8786
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility