Provider Demographics
NPI:1992352660
Name:UWAELUE, MICHAEL AZUBUIKE (FNP-BC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:AZUBUIKE
Last Name:UWAELUE
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 WEST LOOP S STE 525
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3519
Mailing Address - Country:US
Mailing Address - Phone:713-661-7888
Mailing Address - Fax:
Practice Address - Street 1:6565 WEST LOOP S STE 525
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3519
Practice Address - Country:US
Practice Address - Phone:713-661-7888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209538207Q00000X
LA209538363LF0000X
TXAP142044363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2527142Medicaid