MEDICARE: DR. OBINNA C. UZOWULU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	N9144	TX

General Provider Information

NPI Number	:	1003007295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OBINNA C. UZOWULU M.D.

Provider Business Mailing Address
First Line	:	PO BOX 592228
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78259-0161
Country	:	US
Telephone Number	:	210-899-4490
Fax Number	:	210-592-8195

Provider Business Practice Location Address
First Line	:	22250 BULVERDE RD
Second Line	:	SUITE 111
City	:	SAN ANTONIO
State	:	TX
Zip	:	78261-3084
Country	:	US
Telephone Number	:	210-899-4490
Fax Number	:	210-592-8195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	10/05/2015

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