Provider Demographics
NPI:1083010060
Name:EGBUONU, IFEOMA ANTHONIA (MD)
Entity Type:Individual
Prefix:
First Name:IFEOMA
Middle Name:ANTHONIA
Last Name:EGBUONU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3080 JOE BATTLE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2654
Mailing Address - Country:US
Mailing Address - Phone:915-856-7000
Mailing Address - Fax:844-849-3995
Practice Address - Street 1:2270 JOE BATTLE BLVD STE O
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938
Practice Address - Country:US
Practice Address - Phone:915-856-7000
Practice Address - Fax:915-275-0318
Is Sole Proprietor?:No
Enumeration Date:2014-11-18
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR1364207RE0101X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism