Healthcare Provider Details

I. General information

NPI: 1053627562
Provider Name (Legal Business Name): UCHENNA NWEZE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2010
Last Update Date: 07/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 S. EVANS BUILDING B
UVALDE TX
78801-5141
US

IV. Provider business mailing address

908 S. EVANS BUILDING A
UVALDE TX
78801-5141
US

V. Phone/Fax

Practice location:
  • Phone: 830-278-3765
  • Fax: 830-278-3373
Mailing address:
  • Phone: 830-278-5604
  • Fax: 830-278-1836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6053
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN013913
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number27941
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: