Provider Demographics
NPI:1528043676
Name:NJUKI, FREDERICK I (MD)
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:I
Last Name:NJUKI
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 1:286 ED ENGLISH DR STE B
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-8034
Mailing Address - Country:US
Mailing Address - Phone:281-764-1888
Mailing Address - Fax:281-419-3222
Practice Address - Street 1:286 ED ENGLISH DR STE B
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-8034
Practice Address - Country:US
Practice Address - Phone:281-764-1888
Practice Address - Fax:281-419-3222
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2020-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7503208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00359891OtherRAILROAD MEDICARE IND NO
TX8W0770OtherBCBS INDIVIDUAL NUMBER
TX8W0770OtherBCBS INDIVIDUAL NUMBER