Provider Demographics
NPI:1427016393
Name:UGWUIBE, MAURICE N (MD)
Entity type:Individual
Prefix:
First Name:MAURICE
Middle Name:N
Last Name:UGWUIBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 S ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-3109
Mailing Address - Country:US
Mailing Address - Phone:361-888-4745
Mailing Address - Fax:361-888-4795
Practice Address - Street 1:1531 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-3109
Practice Address - Country:US
Practice Address - Phone:361-888-4745
Practice Address - Fax:361-888-4795
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7704207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140166304Medicaid
TX140166304Medicaid
TXF91500Medicare UPIN
TXTXB126059Medicare UPIN