Provider Demographics
NPI:1053956508
Name:NWOSUOCHA, IHECHI NGOZI
Entity type:Individual
Prefix:MRS
First Name:IHECHI
Middle Name:NGOZI
Last Name:NWOSUOCHA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20010 BALLINGER RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4057
Mailing Address - Country:US
Mailing Address - Phone:718-290-0207
Mailing Address - Fax:
Practice Address - Street 1:2400 AUGUSTA DR STE 369
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-4911
Practice Address - Country:US
Practice Address - Phone:713-347-1639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAG05190039363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner