Provider Demographics
NPI:1467175752
Name:ANYIBE, IKECHUKWU DARLINGTON
Entity Type:Individual
Prefix:
First Name:IKECHUKWU
Middle Name:DARLINGTON
Last Name:ANYIBE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4919 FAIRWATER CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2354
Mailing Address - Country:US
Mailing Address - Phone:833-488-7778
Mailing Address - Fax:
Practice Address - Street 1:4919 FAIRWATER CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-2354
Practice Address - Country:US
Practice Address - Phone:833-488-7778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX021852253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care