Individual
BLESSING ONURUKA EZIAGWU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 W MAIN ST STE 220, MESQUITE, TX 75149-4224
(214) 351-3490
Mailing address
7409 WILSHIRE DR, ROWLETT, TX 75089-8883
(214) 434-5115
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1034714
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
426720501
—
TX
Enumeration date
04/14/2021
Last updated
10/05/2021
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