Provider Demographics
NPI:1043765969
Name:NDUA, ANTHONY KARONJI (APRN)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:KARONJI
Last Name:NDUA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 HIGHMEADOW DR
Mailing Address - Street 2:APT, 2028
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-4800
Mailing Address - Country:US
Mailing Address - Phone:832-366-7386
Mailing Address - Fax:
Practice Address - Street 1:1401 WIRT RD STE E2
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-4904
Practice Address - Country:US
Practice Address - Phone:832-583-9060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-20
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131737363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0271970450Medicare NSC