Provider Demographics
NPI:1407648603
Name:NWOGWUGWU, COSMAS ASONYE
Entity type:Individual
Prefix:
First Name:COSMAS
Middle Name:ASONYE
Last Name:NWOGWUGWU
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 1:21212 FM 1098 LOOP UNIT 2912
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VIEW
Mailing Address - State:TX
Mailing Address - Zip Code:77446-4420
Mailing Address - Country:US
Mailing Address - Phone:972-371-9446
Mailing Address - Fax:
Practice Address - Street 1:21212 FM 1098 LOOP UNIT 2912
Practice Address - Street 2:
Practice Address - City:PRAIRIE VIEW
Practice Address - State:TX
Practice Address - Zip Code:77446-4420
Practice Address - Country:US
Practice Address - Phone:972-371-9446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1067642363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health