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General NPI Number Information
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NPI Number | 1831654045
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Entity Type | Organization
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Legal Business Name | RAPHAEL E NWOJO MD PA
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Dates
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Enumeration Date | 02/01/2019
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 540 W 5TH ST STE 410
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City | ODESSA
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State | TX
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Zip | 79761-5067
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Country | US
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Telephone | 432-640-6360
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3146
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City | ODESSA
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State | TX
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Zip | 79760-3146
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Country | US
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Telephone | 432-640-6360
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Fax | 432-640-4759
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAPHAEL EZERA NWOJO
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Credential | MD
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Telephone | 432-640-6360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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