Individual
IJEOMA O NWAEZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10701 VINTAGE PRESERVE PKWY, HOUSTON, TX 77070-2158
(713) 442-1500
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-0000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
P4898
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
P4898
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
356834702
—
TX
05
—
356834703
—
TX
Enumeration date
08/31/2005
Last updated
06/14/2021
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