Individual
CHIAGOZIE U NWASURUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
(903) 877-3451
Mailing address
PO BOX 731912, DALLAS, TX 75373-1912
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K1594
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118155402
—
TX
Enumeration date
10/21/2005
Last updated
09/19/2016
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