Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | K0608 | TX |
N | 207R00000X | Internist | K0608 | TX |
N | 111NI0900X | Internist | K0608 | TX |
N | 2081P2900X | Pain Medicine | K0608 | TX |
NPI | 1497718688 |
---|---|
Provider Name | Dr. John Chike Anigbogu |
First Address | Houston, TX 77096-5438 |
Second Address | Houston, TX 77096-5438 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F 91402 | (02) | TX |
Z000063H8 | (05) | TX |