Provider Demographics
NPI:1235415530
Name:AGANIGBO, ADOLPHUS NNAEMEKA (NP-C)
Entity Type:Individual
Prefix:MR
First Name:ADOLPHUS
Middle Name:NNAEMEKA
Last Name:AGANIGBO
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2121 BROOK TREE DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2873
Mailing Address - Country:US
Mailing Address - Phone:214-448-6600
Mailing Address - Fax:214-440-2186
Practice Address - Street 1:6363 N STATE HIGHWAY 161 STE 100
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-2239
Practice Address - Country:US
Practice Address - Phone:469-200-3272
Practice Address - Fax:888-262-9948
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX723773363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health