Provider Demographics
NPI:1285161273
Name:OWORU, SANDRA ELAINE
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:ELAINE
Last Name:OWORU
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 1:12236 BOB WHITE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-5291
Mailing Address - Country:US
Mailing Address - Phone:713-729-3066
Mailing Address - Fax:
Practice Address - Street 1:12236 BOB WHITE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-5291
Practice Address - Country:US
Practice Address - Phone:713-729-3066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 3747P1801X
TX018376253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant