Provider Demographics
NPI:1902618978
Name:IHESIABA, STELLA UZOAMAKA
Entity type:Individual
Prefix:
First Name:STELLA
Middle Name:UZOAMAKA
Last Name:IHESIABA
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 1:9847 MARBACH BND
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-1699
Mailing Address - Country:US
Mailing Address - Phone:210-300-0478
Mailing Address - Fax:
Practice Address - Street 1:9730 WESTOVER HILLS BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4841
Practice Address - Country:US
Practice Address - Phone:210-366-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1189129363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health