MEDICARE: OGECHI ROSELINE AMAGWULA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1437853488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OGECHI ROSELINE AMAGWULA

Provider Business Mailing Address
First Line	:	1555 LAZY SPRING DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-5223
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1555 LAZY SPRING DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-5223
Country	:	US
Telephone Number	:	832-441-2224
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2023
Last Update Date	:	03/27/2023

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Directions to “ OGECHI ROSELINE AMAGWULA ” Practice Location

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