Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | BP10040280 | TX |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | P6428 | TX |
NPI | 1003102732 |
---|---|
Provider Name | Dr. Eberenne F Igbokwe |
First Address | Houston, TX 77054-3905 |
Second Address | Houston, TX 77054-3905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2011 |
Last Update Date | 17/05/2015 |