Provider Demographics
NPI:1508406018
Name:EWUZIE, DAVIDSON IHEANYICHUKWU (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:DAVIDSON
Middle Name:IHEANYICHUKWU
Last Name:EWUZIE
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2719 CUTTER CT
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-1625
Mailing Address - Country:US
Mailing Address - Phone:832-988-9577
Mailing Address - Fax:
Practice Address - Street 1:7505 FANNIN ST STE 170
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1941
Practice Address - Country:US
Practice Address - Phone:713-702-2670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144404363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health