Provider Demographics
NPI:1497718688
Name:ANIGBOGU, JOHN CHIKE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHIKE
Last Name:ANIGBOGU
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 1:11000 FONDREN RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-5438
Mailing Address - Country:US
Mailing Address - Phone:713-271-2800
Mailing Address - Fax:713-271-6697
Practice Address - Street 1:11000 FONDREN RD
Practice Address - Street 2:BUILDING # A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-5438
Practice Address - Country:US
Practice Address - Phone:713-271-2800
Practice Address - Fax:713-271-6697
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0608204C00000X, 2081P2900X, 208VP0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Not Answered2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Not Answered208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXZ000063H8Medicaid
TXZ000063H8Medicaid
TXF 91402Medicare UPIN