Healthcare Provider Details

I. General information

NPI: 1922556083
Provider Name (Legal Business Name): UGORJI RADIOLOGY CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2016
Last Update Date: 10/07/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 TILLERY ST STE 12
AUSTIN TX
78702-3751
US

IV. Provider business mailing address

701 TILLERY ST STE 12 PMB 296
AUSTIN TX
78702-3751
US

V. Phone/Fax

Practice location:
  • Phone: 682-888-0717
  • Fax: 682-888-5686
Mailing address:
  • Phone: 682-888-0717
  • Fax: 682-888-5686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberDR.0055625
License Number StateCO

VIII. Authorized Official

Name: JOSEPH ONUOHA UGORJI
Title or Position: CEO
Credential: D.O.
Phone: 682-888-0717