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Ikechukwu Osuji, M.d Pa
Medical Specialty Clinic/Center in Desoto, Texas
NPI 1407994056

Ikechukwu Osuji, M.d Pa is a Medical Specialty Clinic/Center based in Desoto, TX and is specialized in Medical Specialty. Ikechukwu Osuji, M.d Pa practices in Desoto, TX. The NPI Number for Ikechukwu Osuji, M.d Pa is 1407994056 and holds a License No. K6669 (Texas).

The current practice location address for Ikechukwu Osuji, M.d Pa is 1110 E. Pleasant Run Road, Desoto, TX and can be reached out via phone at 972-230-8881 and via fax at 972-230-8810.

Location: 1110 E. Pleasant Run Road, Desoto, TX, 75115
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1407994056
Provider Name
Ikechukwu Osuji, M.d Pa
Credential
Provider Entity Type
Organization
Address
1110 E. Pleasant Run Road, Desoto, TX, 75115
Phone Number
972-230-8881
Fax Number
972-230-8810
Provider Enumeration Date
02/02/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0076QJ 01 TX BLUE CROSS BLUE SHIELD
122225912 05 TX
165471701 05 TX
institution
Provider Business Practice Location Address Details
Address
1110 E. Pleasant Run Road
City
Desoto
State
Texas
Zip
75115
Phone Number
972-230-8881
Fax Number
972-230-8810
person
Provider Business Mailing Address Details
Address
1110 E. Pleasant Run Road
City
Desoto
State
Texas
Zip
75115
Phone Number
972-230-8881
Fax Number
972-230-8810
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
K6669 (Texas)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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