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General NPI Number Information
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NPI Number | 1881576155
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Entity Type | Organization
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Legal Business Name | NUDOCARE PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 2698 N GALLOWAY AVE STE 107
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City | MESQUITE
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State | TX
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Zip | 75150-6390
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Country | US
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Telephone | 856-952-6558
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Fax |
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Provider Business Mailing Address
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Address Line | 11249 MAJESTIC PRINCE CIR
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City | FRISCO
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State | TX
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Zip | 75035-1187
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHIOMA ENYERIBE
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Credential | MD
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Telephone | 214-646-1606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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