=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053229286
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MINDFUSE HEALTH PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/29/2026
-----------------------------------------------------
Last Update Date | 08/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5900 BALCONES DR STE 23023
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78731-4257
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-211-9212
-----------------------------------------------------
Fax | 877-497-2909
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5900 BALCONES DR STE 23023
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78731-4257
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-211-9212
-----------------------------------------------------
Fax | 877-497-2909
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | CHINEMEREM YVONNE UGORJI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 832-402-4093
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RB0002X
-----------------------------------------------------
Taxonomy Name | Obesity Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------