Healthcare Provider Details

I. General information

NPI: 1740455278
Provider Name (Legal Business Name): MICHELLE ERUMU NWOSU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7951 KATY FWY STE E
HOUSTON TX
77024-1948
US

IV. Provider business mailing address

7951 KATY FWY STE E
HOUSTON TX
77024-1948
US

V. Phone/Fax

Practice location:
  • Phone: 346-608-4121
  • Fax: 877-569-3207
Mailing address:
  • Phone: 346-608-4121
  • Fax: 877-569-3207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ1873
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberQ1873
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberQ1873
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: