Healthcare Provider Details

I. General information

NPI: 1487911210
Provider Name (Legal Business Name): STANISLAUS NWAFOR UZOIGWE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 09/10/2020
Certification Date: 08/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 N US HIGHWAY 83
ZAPATA TX
78076-3578
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 956-765-0770
  • Fax: 956-765-0660
Mailing address:
  • Phone: 956-488-1200
  • Fax: 956-488-0550

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: 956-487-3802