Provider Demographics
NPI:1114565025
Name:MACAULAY E NWOJO MD PLLC
Entity Type:Organization
Organization Name:MACAULAY E NWOJO MD PLLC
Other - Org Name:MIDESSA NEUROSURGERY AND COMPLEX SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MACAULAY
Authorized Official - Middle Name:E
Authorized Official - Last Name:NWOJO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-434-4963
Mailing Address - Street 1:PO BOX 15007
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79768-5007
Mailing Address - Country:US
Mailing Address - Phone:432-558-7000
Mailing Address - Fax:432-214-2400
Practice Address - Street 1:8050 E HIGHWAY 191 STE 250
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765-8613
Practice Address - Country:US
Practice Address - Phone:432-558-7000
Practice Address - Fax:432-214-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty