Healthcare Provider Details

I. General information

NPI: 1851691307
Provider Name (Legal Business Name): STANISLAUS NWAFOR UZOIGWE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 N GRANT ST STE 1
ROMA TX
78584-5429
US

IV. Provider business mailing address

201 E 2ND ST
RIO GRANDE CITY TX
78582-3803
US

V. Phone/Fax

Practice location:
  • Phone: 956-847-4007
  • Fax: 956-488-0550
Mailing address:
  • Phone: 956-488-1200
  • Fax: 956-488-9500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ANA FALCON
Title or Position: CREDENTIALING CLERK
Credential:
Phone: 956-488-1200