=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629039938
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | IKEDINOBI UGOCHUKWU ENI MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2006
-----------------------------------------------------
Last Update Date | 02/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9319 PINECROFT DR STE 120
-----------------------------------------------------
City | THE WOODLANDS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77380-3485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-321-1946
-----------------------------------------------------
Fax | 936-273-5774
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9319 PINECROFT DR STE 120
-----------------------------------------------------
City | THE WOODLANDS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77380-3485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-321-1946
-----------------------------------------------------
Fax | 936-273-5774
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | K6843
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | K6843
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------