MEDICARE: EMMANUEL ULONNAYA AGOH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	N7668	TX
2	208D00000X	General Practice Physician	N7668	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508034927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMANUEL ULONNAYA AGOH MD

Provider Business Mailing Address
First Line	:	8610 MARTIN LUTHER KING BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77033-2308
Country	:	US
Telephone Number	:	713-734-1697
Fax Number	:	713-733-9316

Provider Business Practice Location Address
First Line	:	8610 MARTIN LUTHER KING BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77033-2308
Country	:	US
Telephone Number	:	713-734-1697
Fax Number	:	713-733-9316

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2008
Last Update Date	:	04/21/2025

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