Provider Demographics
NPI:1790648293
Name:OSUOZAH, MICHAEL CHINEDU
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CHINEDU
Last Name:OSUOZAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 WILDFIRE CV
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-5056
Mailing Address - Country:US
Mailing Address - Phone:512-506-0091
Mailing Address - Fax:
Practice Address - Street 1:251 WILDFIRE CV
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-5056
Practice Address - Country:US
Practice Address - Phone:512-506-0091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-03
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42079390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program