Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | M9800 | TX |
N | 207R00000X | Internist | M9800 | TX |
N | 111NI0900X | Internist | M9800 | TX |
N | 207RC0000X | Internist - Cardiovascular Disease | M9800 | TX |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | M9800 | TX |
N | 208000000X | Pediatrician | M9800 | TX |
NPI | 1306095021 |
---|---|
Provider Name | Dr. Ijeoma Ananaba Ekeruo |
First Address | Houston, TX 77030-1501 |
Second Address | Houston, TX 77026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2008 |
Last Update Date | 05/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
198055902 | (05) | TX |