Provider Demographics
NPI:1396370003
Name:IHEME, KINGSLEY GEORGE (FNP)
Entity Type:Individual
Prefix:
First Name:KINGSLEY
Middle Name:GEORGE
Last Name:IHEME
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7076 POST OAK CIR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3065
Mailing Address - Country:US
Mailing Address - Phone:832-457-1417
Mailing Address - Fax:
Practice Address - Street 1:1806 RUNNELS ST
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8288
Practice Address - Country:US
Practice Address - Phone:956-230-3181
Practice Address - Fax:956-230-3182
Is Sole Proprietor?:No
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145205207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease