Provider Demographics
NPI:1518242213
Name:IZAH, UZOAKU NDIDI
Entity type:Individual
Prefix:
First Name:UZOAKU
Middle Name:NDIDI
Last Name:IZAH
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 1:12023 BISSONNET ST
Mailing Address - Street 2:402
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-1456
Mailing Address - Country:US
Mailing Address - Phone:713-261-5657
Mailing Address - Fax:
Practice Address - Street 1:12023 BISSONNET ST
Practice Address - Street 2:402
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-1456
Practice Address - Country:US
Practice Address - Phone:713-261-5657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD-02-02251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health