Provider Demographics
NPI:1972285443
Name:EMENADIKE, CHIGOZIE FRANCIS
Entity Type:Individual
Prefix:
First Name:CHIGOZIE
Middle Name:FRANCIS
Last Name:EMENADIKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4521 W PIONEER DR APT 308
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-3814
Mailing Address - Country:US
Mailing Address - Phone:973-855-6236
Mailing Address - Fax:
Practice Address - Street 1:4521 W PIONEER DR APT 308
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-3814
Practice Address - Country:US
Practice Address - Phone:973-855-6236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47687305172A00000X, 343800000X
TX347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No172A00000XOther Service ProvidersDriver
No347C00000XTransportation ServicesPrivate Vehicle