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General NPI Number Information
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NPI Number | 1104489681
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Entity Type | Individual
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Provider Name | FORTUNE CHIMDINDU UNEGBU MD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2019
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 1361 HERO WAY STE 100
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City | LEANDER
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State | TX
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Zip | 78641-5579
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Country | US
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Telephone | 512-244-2273
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Fax | 512-862-4739
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Provider Business Mailing Address
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Address Line | PO BOX 10597
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City | AUSTIN
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State | TX
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Zip | 78766-1597
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Country | US
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Telephone | 512-420-0186
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Fax | 903-200-5107
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | V7092
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License Number State | TX
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