MEDICARE: DR. IJEOMA ADAEZE OGUAGHA 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	208000000X	Pediatrics Physician	274675	NY
2	208000000X	Pediatrics Physician	S8888	TX

General Provider Information

NPI Number	:	1265793822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IJEOMA ADAEZE OGUAGHA M.D.

Provider Business Mailing Address
First Line	:	7206 AUTUMN SUN DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-6900
Country	:	US
Telephone Number	:	646-797-7479
Fax Number	:

Provider Business Practice Location Address
First Line	:	13111 WESTHEIMER RD STE 250
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-5520
Country	:	US
Telephone Number	:	346-635-9028
Fax Number	:

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

Provider Enumeration Date	:	05/30/2012
Last Update Date	:	09/19/2024

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