Provider Demographics
NPI:1558922500
Name:AZUOGU, NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:AZUOGU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 FANNIN ST STE 1000
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2957
Mailing Address - Country:US
Mailing Address - Phone:713-797-9999
Mailing Address - Fax:713-795-4657
Practice Address - Street 1:7900 FANNIN ST STE 1000
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2957
Practice Address - Country:US
Practice Address - Phone:713-797-9999
Practice Address - Fax:713-795-4657
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10067717207Q00000X
TXT3920207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine