Provider Demographics
NPI:1609814342
Name:FREDERICK NJUKI MD, PA
Entity Type:Organization
Organization Name:FREDERICK NJUKI MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:I
Authorized Official - Last Name:NJUKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-764-1888
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDF3709OtherRAILROAD MEDICARE GRP
TX183136401Medicaid
0032NTOtherBCBS GROUP NUMBER
TX183136401Medicaid
TX00X041Medicare PIN