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OIG exclusion detail

ITA UDEOBONG

This page shows an imported LEIE row. Verify details against the official OIG source before acting.

Imported OIG rowOfficial OIG source
NPI
1538276803
Name
ITA ANDREW JR UDEOBONG
Address
10806 ROLLER MILL LANE, SUGAR LAND, TX, 77498
Specialty
DME - INCONTINENCE K
Exclusion type
1128a1
Exclusion date
20121120
Reinstatement date
00000000
Waiver
00000000

Source snapshot

Imported: May 05, 2026

Rows: 83,001

Checksum: 3a10b8ee0e4691855f74ce65a5e733672474291f79ed1f7cef163328d945e9a7

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