Provider Demographics
NPI:1740722917
Name:IKWUAGWU, OSCAR
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:IKWUAGWU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 REIMS RD
Mailing Address - Street 2:APT 1404
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3007
Mailing Address - Country:US
Mailing Address - Phone:713-478-9031
Mailing Address - Fax:
Practice Address - Street 1:6001 REIMS RD
Practice Address - Street 2:APT 1404
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3007
Practice Address - Country:US
Practice Address - Phone:713-478-9031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver