Healthcare Provider Details

I. General information

NPI: 1649756461
Provider Name (Legal Business Name): ADAKU IJEOMA NWOSU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADAKU IJEOMA ANUEBUNWA MD

II. Dates (important events)

Enumeration Date: 07/15/2018
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1951 SOUTHMORE AVE.
PASADENA TX
77502
US

IV. Provider business mailing address

PO BOX 66308
HOUSTON TX
77266-6308
US

V. Phone/Fax

Practice location:
  • Phone: 832-548-5000
  • Fax: 832-548-5000
Mailing address:
  • Phone: 832-548-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number29093
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberW5904
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: