Provider Demographics
NPI:1598999062
Name:IHEUKWUMERE, ESTHER ORIEAKU (MD)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:ORIEAKU
Last Name:IHEUKWUMERE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 CLARKSVILLE ST
Mailing Address - Street 2:SUITE 160
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-6097
Mailing Address - Country:US
Mailing Address - Phone:903-785-3300
Mailing Address - Fax:903-785-3310
Practice Address - Street 1:1055 CLARKSVILLE ST
Practice Address - Street 2:SUITE 160
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-6097
Practice Address - Country:US
Practice Address - Phone:903-785-3300
Practice Address - Fax:903-785-3310
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3355207RN0300X
OK29475207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2985624-01Medicaid
OK200441810 AMedicaid
TXTXB153908Medicare PIN
TX2985624-01Medicaid