Provider Demographics
NPI:1689618555
Name:UZOIGWE, STANISLAUS NWAFOR (MD PA)
Entity Type:Individual
Prefix:
First Name:STANISLAUS
Middle Name:NWAFOR
Last Name:UZOIGWE
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:STANISLAUS
Other - Middle Name:NWAFOR
Other - Last Name:UZOIGWE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD PA
Mailing Address - Street 1:201 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-3803
Mailing Address - Country:US
Mailing Address - Phone:956-488-1200
Mailing Address - Fax:956-488-9500
Practice Address - Street 1:201 E 2ND ST
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-3803
Practice Address - Country:US
Practice Address - Phone:956-488-1200
Practice Address - Fax:956-488-9500
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4155208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150513303Medicaid