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Organization

PREMIER UROLOGY, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CORDELL OKEZIE NWOKEJI M.D. (PRESIDENT)
(281) 358-0171
Entity
Organization

Contact information

Practice address
22751 PROFESSIONAL DR, SUITE 270, KINGWOOD, TX 77339-6021
(281) 358-0171
(281) 358-2194
Mailing address
P. O. BOX 4346, DEPT. 183, HOUSTON, TX 77210-4346
(713) 554-5304
(713) 554-5320

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
M1988
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0010RV
BLUE CROSS BLUE SHIELD GROUP
TX
01
00Z557
MEDICARE GROUP
TX
Enumeration date
07/14/2008
Last updated
11/30/2011
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