Provider Demographics
NPI:1639126501
Name:OGBOGU, HENRY U (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:U
Last Name:OGBOGU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:609 SAINT JAMES PL
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2751
Mailing Address - Country:US
Mailing Address - Phone:214-587-4043
Mailing Address - Fax:972-304-3291
Practice Address - Street 1:2700 W PLEASANT RUN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1079
Practice Address - Country:US
Practice Address - Phone:972-230-8881
Practice Address - Fax:972-230-8810
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ8077207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F2004Medicare ID - Type Unspecified
TXF75976Medicare UPIN