Provider Demographics
NPI:1346554086
Name:EDEKI, IFEYINWA CHRISTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:IFEYINWA
Middle Name:CHRISTINE
Last Name:EDEKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:IFEYINWA
Other - Last Name:IZUNDU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:26400 KUYKENDAHL RD STE C180-217
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-2882
Mailing Address - Country:US
Mailing Address - Phone:832-824-6845
Mailing Address - Fax:832-825-8915
Practice Address - Street 1:1919 S BRAESWOOD BLVD STE 5330
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:832-824-6845
Practice Address - Fax:832-825-8915
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6274208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218384001Medicaid