Individual
MS. ALICE ITA UDEOBONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7402 PAVILION DR, HOUSTON, TX 77083-6927
(832) 886-4539
(832) 886-4690
Mailing address
7402 PAVILION DR, HOUSTON, TX 77083-6927
(832) 886-4539
(832) 886-4690
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
011219
TX
390200000X
Student in an Organized Health Care Education/Training Program
9809
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9809
CHES
TX
Enumeration date
10/16/2006
Last updated
05/13/2019
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