Provider Demographics
NPI:1861994667
Name:UMEH, CORDELIA CHINELO (PTA)
Entity type:Individual
Prefix:
First Name:CORDELIA
Middle Name:CHINELO
Last Name:UMEH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22011 SKYRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-6350
Mailing Address - Country:US
Mailing Address - Phone:281-650-0715
Mailing Address - Fax:
Practice Address - Street 1:22011 SKYRIDGE LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-6350
Practice Address - Country:US
Practice Address - Phone:281-650-0715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2040335225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant