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General NPI Number Information
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NPI Number | 1952352510
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Entity Type | Individual
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Provider Name | HENRY WAKIKU NTENDE MD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 8050 HIGHWAY 191 SUITE 202
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City | ODESSA
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State | TX
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Zip | 79765-8613
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Country | US
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Telephone | 432-312-6065
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Fax |
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Provider Business Mailing Address
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Address Line | 11816 INWOOD RD
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City | DALLAS
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State | TX
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Zip | 75244-8011
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Country | US
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Telephone | 501-658-8830
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 34790
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101245604
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 0101245604
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | P0645
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | E3610
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License Number State | AR
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