Provider Demographics
NPI:1194974006
Name:FADAKA, UKACHI ONWERE (APN)
Entity type:Individual
Prefix:
First Name:UKACHI
Middle Name:ONWERE
Last Name:FADAKA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:UKACHI
Other - Middle Name:ONWERE
Other - Last Name:ANENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:15523 CABILDO DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-2452
Mailing Address - Country:US
Mailing Address - Phone:832-466-1631
Mailing Address - Fax:
Practice Address - Street 1:15523 CABILDO DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-2452
Practice Address - Country:US
Practice Address - Phone:281-988-8118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX570882363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner