Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 22078 | TX |
NPI | 1093881203 |
---|---|
Provider Name | Dr. Daniela Uchechukwu Usifoh |
First Address | Houston, TX 77004-6900 |
Second Address | Houston, TX 77004-6900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G60155-1 | CHIP (01) | TX |