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General NPI Number Information
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NPI Number | 1962937789
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Entity Type | Individual
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Provider Name | SYBIL IJEOMA AGU MBADUGHA MD
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Gender | Female
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Dates
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Enumeration Date | 04/30/2017
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 2060 SPACE PARK DR STE 208
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City | HOUSTON
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State | TX
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Zip | 77058-3675
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Country | US
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Telephone | 713-441-6455
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Fax | 281-333-0227
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Provider Business Mailing Address
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Address Line | 2060 SPACE PARK DR STE 208
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City | HOUSTON
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State | TX
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Zip | 77058-3675
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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 |
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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 | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | V3379
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License Number State | TX
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