Provider Demographics
NPI:1720581432
Name:HOLY CROSS OBGYN
Entity Type:Organization
Organization Name:HOLY CROSS OBGYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MADUKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ODOGWU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-546-9114
Mailing Address - Street 1:1010 N BELT LINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-1770
Mailing Address - Country:US
Mailing Address - Phone:469-862-3756
Mailing Address - Fax:469-862-3766
Practice Address - Street 1:1010 N BELT LINE RD STE 104
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-1770
Practice Address - Country:US
Practice Address - Phone:864-546-9114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-09
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty