Provider Demographics
NPI:1043086655
Name:KABBA, UMU
Entity type:Individual
Prefix:
First Name:UMU
Middle Name:
Last Name:KABBA
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 1:3524 PRAIRIE ROSE TRL
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-2329
Mailing Address - Country:US
Mailing Address - Phone:801-604-9384
Mailing Address - Fax:
Practice Address - Street 1:3524 PRAIRIE ROSE TRL
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-2329
Practice Address - Country:US
Practice Address - Phone:801-604-9384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor