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NPI Code Detail

MEDICARE: MR. ADOLPHUS NNAEMEKA AGANIGBO NP-C

MEDICARE: MR. ADOLPHUS NNAEMEKA AGANIGBO NP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner723773TX

General Provider Information

NPI Number : 1235415530
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ADOLPHUS NNAEMEKA AGANIGBO NP-C
Provider Business Mailing Address
First Line : 2121 BROOK TREE DR
Second Line :
City : GARLAND
State : TX
Zip : 75040-2873
Country : US
Telephone Number : 214-448-6600
Fax Number : 214-440-2186
Provider Business Practice Location Address
First Line : 6363 N STATE HIGHWAY 161 STE 100
Second Line :
City : IRVING
State : TX
Zip : 75038-2239
Country : US
Telephone Number : 469-200-3272
Fax Number : 888-262-9948
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2011
Last Update Date : 03/24/2023

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