Provider Demographics
NPI:1578576237
Name:ASUMUGHA, KINGSLEY N (MD)
Entity Type:Individual
Prefix:DR
First Name:KINGSLEY
Middle Name:N
Last Name:ASUMUGHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11003 RESOURCE PKWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6141
Mailing Address - Country:US
Mailing Address - Phone:281-464-9100
Mailing Address - Fax:281-464-8864
Practice Address - Street 1:11003 RESOURCE PKWY
Practice Address - Street 2:SUITE 104
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6141
Practice Address - Country:US
Practice Address - Phone:281-464-9100
Practice Address - Fax:281-464-8864
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ6860207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF83166Medicare UPIN
TXAS000N44LMedicare ID - Type Unspecified