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General NPI Number Information
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NPI Number | 1386805919
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Entity Type | Individual
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Provider Name | NDIDI UFONDU DPM
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Gender | Female
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 319 OSLER DR STE 150
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City | ARLINGTON
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State | TX
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Zip | 76010-5407
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Country | US
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Telephone | 817-538-5291
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Fax | 682-238-0738
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Provider Business Mailing Address
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Address Line | PO BOX 210773
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City | BEDFORD
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State | TX
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Zip | 76095-7773
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Country | US
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Telephone | 817-330-9698
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Fax |
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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 | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 25MD00296800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 3008
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 3008
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 25MD00296800
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License Number State | NJ
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