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General NPI Number Information
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NPI Number | 1710178181
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Entity Type | Organization
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Legal Business Name | STANISLAUS NWAFOR UZOIGWE MD PA
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 1505 N GRANT ST STE 1
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City | ROMA
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State | TX
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Zip | 78584-5429
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Country | US
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Telephone | 956-849-4700
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Fax | 956-849-4704
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Provider Business Mailing Address
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Address Line | 201 E 2ND ST
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-3803
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Country | US
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Telephone | 956-488-1200
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Fax | 956-488-9500
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANA FALCON
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Credential |
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Telephone | 956-488-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | L4155
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License Number State | TX
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