Provider Demographics
NPI:1942041637
Name:SCARIBUN PROFESSIONAL LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:SCARIBUN PROFESSIONAL LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHIKWELU
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:UMEH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:443-286-0257
Mailing Address - Street 1:24527 MERLOT WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-2625
Mailing Address - Country:US
Mailing Address - Phone:443-286-0257
Mailing Address - Fax:210-888-9299
Practice Address - Street 1:24527 MERLOT WAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-2625
Practice Address - Country:US
Practice Address - Phone:443-286-0257
Practice Address - Fax:210-888-9299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty