Provider Demographics
NPI:1043415656
Name:IKE ENI, M.D., P.A.
Entity Type:Organization
Organization Name:IKE ENI, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:IKE
Authorized Official - Middle Name:U
Authorized Official - Last Name:ENI
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:936-321-1946
Mailing Address - Street 1:9319 PINECROFT DR STE 120
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3485
Mailing Address - Country:US
Mailing Address - Phone:936-321-1946
Mailing Address - Fax:936-321-8271
Practice Address - Street 1:9319 PINECROFT DR STE 120
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3485
Practice Address - Country:US
Practice Address - Phone:936-321-1946
Practice Address - Fax:936-321-8271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6843207R00000X
207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00611UMedicare ID - Type Unspecified