Provider Demographics
NPI:1104207844
Name:KANU, OBIAJULU U (MD)
Entity Type:Individual
Prefix:
First Name:OBIAJULU
Middle Name:U
Last Name:KANU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 AUBURN HILLS PKWY STE 801
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-3572
Mailing Address - Country:US
Mailing Address - Phone:214-796-8579
Mailing Address - Fax:
Practice Address - Street 1:2001 AUBURN HILLS PKWY STE 801
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-3572
Practice Address - Country:US
Practice Address - Phone:214-796-8579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS6222207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX413966901Medicaid