Healthcare Provider Details

I. General information

NPI: 1982244174
Provider Name (Legal Business Name): AGATHA NWOSU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11515 BROOKSIDE ARBOR LN
RICHMOND TX
77406-2801
US

IV. Provider business mailing address

11515 BROOKSIDE ARBOR LN
RICHMOND TX
77406-2801
US

V. Phone/Fax

Practice location:
  • Phone: 832-322-5462
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1166671
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: