Katy Pediatric Neurology

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

Q1873 Issued in TX

Legal business name

KATY PEDIATRIC NEUROLOGY

Practice address

2703 Mayfield Ridge LN
Katy, TX 77494-7169

Phone

(617) 458-1100

Fax

(281) 946-5664

NPI assigned

Apr 5, 2017

Last updated

Apr 5, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michelle Erumu Nwosu, MD

Title

Director

Phone

(617) 458-1100

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491350400000",
    "number": "1487187514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 MAYFIELD RIDGE LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774947169",
            "telephone_number": "617-458-1100",
            "fax_number": "281-946-5664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 MAYFIELD RIDGE LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774947169",
            "telephone_number": "617-458-1100",
            "fax_number": "281-946-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATY PEDIATRIC NEUROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-05",
        "last_updated": "2017-04-05",
        "status": "A",
        "authorized_official_last_name": "NWOSU",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ERUMU",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "617-458-1100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "TX",
            "license": "Q1873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katy Modern Dentistry and Orthodontics PC (Katy Modern Dentistry and Orthodontics)
• Katy Olive Dental PLLC
• Katy Pain and Spine, PLLC
• Katy Pain Specialists, PLLC
• Katy Park Pediatric Dentistry PLLC
• Katy Pediatric Physical Therapy
• Katy Periodontics Management Inc
• Katy Periodontology and Oral Surgery PLLC
• Katy Personal Assistance Services
• Katy Pharmacy & Drug Store (Katy Pharmacy 3)

• Neurology with Special Qualifications in Child Neurology Physician in Katy, TX
• Providers in Katy, TX by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.