Healthcare Provider Details

I. General information

NPI: 1508154436
Provider Name (Legal Business Name): ENYIOMA A MUOLOKWU PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2011
Last Update Date: 07/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7602 BRIGHT LAKE BEND LN
RICHMOND TX
77407-4494
US

IV. Provider business mailing address

7602 BRIGHT LAKE BEND LN
RICHMOND TX
77407-4494
US

V. Phone/Fax

Practice location:
  • Phone: 832-816-0244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberN2678
License Number StateTX

VIII. Authorized Official

Name: ENYIOMA ANULI MUOLOKWU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 832-816-0244