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General NPI Number Information
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NPI Number | 1366369621
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Entity Type | Organization
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Legal Business Name | BOA PSYCHIATRY PLLC
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Dates
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Enumeration Date | 06/29/2026
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Last Update Date | 06/29/2026
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Provider Practice Location Address
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Address Line | 4818 COUNTY ROAD 219 UNIT 801
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City | TYLER
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State | TX
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Zip | 75707-4404
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Country | US
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Telephone | 862-250-1352
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Fax | 608-305-8949
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Provider Business Mailing Address
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Address Line | 4818 COUNTY ROAD 219 UNIT 801
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City | TYLER
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State | TX
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Zip | 75707-4404
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Country | US
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Telephone | 862-250-1352
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Fax | 608-305-8949
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Authorized Official
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Title or Position | CEO/MD
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Name | DR. ADANZE NGOZI AGUWA
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Credential | MD
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Telephone | 862-250-1352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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