Provider Demographics
NPI:1932736576
Name:OGUDO, JUDITH JUMMAI
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:JUMMAI
Last Name:OGUDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:JUMMAI
Other - Last Name:BARRAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:6726 CARLY PARK WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-1363
Mailing Address - Country:US
Mailing Address - Phone:281-210-8634
Mailing Address - Fax:
Practice Address - Street 1:6726 CARLY PARK WAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-1363
Practice Address - Country:US
Practice Address - Phone:281-210-8634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9616914163W00000X
253Z00000X
TX344795164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse