Provider Demographics
NPI:1316105117
Name:OSUAGWU, EDDIE CHIEDOZIE (MS, LCDC, SAP, ADCII)
Entity type:Individual
Prefix:MR
First Name:EDDIE
Middle Name:CHIEDOZIE
Last Name:OSUAGWU
Suffix:
Gender:M
Credentials:MS, LCDC, SAP, ADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N GALLOWAY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-4315
Mailing Address - Country:US
Mailing Address - Phone:214-324-5400
Mailing Address - Fax:972-329-5000
Practice Address - Street 1:303 N GALLOWAY AVE STE A
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-4315
Practice Address - Country:US
Practice Address - Phone:214-324-5400
Practice Address - Fax:972-329-5000
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7596101YA0400X
TX70461101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)