Provider Demographics
NPI:1871373811
Name:UGO, ADAMMA SHANNON (MED)
Entity type:Individual
Prefix:
First Name:ADAMMA
Middle Name:SHANNON
Last Name:UGO
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5861 W GULF BANK RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-4120
Mailing Address - Country:US
Mailing Address - Phone:713-454-7840
Mailing Address - Fax:
Practice Address - Street 1:5861 W GULF BANK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-4120
Practice Address - Country:US
Practice Address - Phone:713-454-7840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1486103174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist