MEDICARE: BEATRICE U OSIZUGBO

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	163WP0200X	Pediatric Registered Nurse	596251	TX

General Provider Information

NPI Number	:	1619445616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRICE U OSIZUGBO

Provider Business Mailing Address
First Line	:	9318 CARMALEE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77075-4907
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9318 CARMALEE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77075-4907
Country	:	US
Telephone Number	:	713-550-2986
Fax Number	:

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

Provider Enumeration Date	:	11/07/2018
Last Update Date	:	11/07/2018

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Directions to “ BEATRICE U OSIZUGBO ” Practice Location

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